Drug overdose is the number one cause of accidental death in Connecticut, where someone is more likely to die from a drug overdose than from a car accident.

Researchers are seeking to understand how to best prevent overdoses. A new Yale-led retrospective cohort study published in Drug and Alcohol Dependence examined the efficacy of a range of treatments for patients who survived an opioid overdose and identified treatments that are most successful in preventing subsequent overdoses.

The investigators examined data of over 4,000 overdose survivors spanning a 19-month period, homing in on treatment modalities like medication and inpatient rehabilitation. The analysis found that people who took methadone or buprenorphine had a lower risk of further overdoses compared to those who did not take the medications.

“This real-world experience confirms what we see in clinical trials,” says Benjamin Howell, MD, MPH, assistant professor of medicine (general medicine) and lead author of the study. “Medications are shown to improve a range of outcomes, like treatment retention, drug use, criminalized behavior, and even employment.”

Methadone and buprenorphine are controlled substances, and are available by prescription only. These medications are used to curb opioid withdrawal symptoms and ongoing treatment.

“Our access to a unique combination of state-level datasets allowed us to consider multiple treatments in our statistical models and draw meaningful conclusions about people’s risk for overdose,” says Anne C. Black, Ph.D., associate professor of medicine (general medicine) and co-author.

The research team also found no statistical differences between inpatient treatment, such as rehabilitation or detox, and receiving no treatment. This means inpatient treatment has no independent effect on subsequent overdoses. The finding, Howell notes, highlights the need for medications to be provided in conjunction with inpatient treatment.

“These medications are the gold standard for the treatment of opioid use disorder by the NIH and other authoritative bodies, and they are effective because they prevent withdrawal and decrease craving,” says David Fiellin, MD, professor of medicine (general medicine), emergency medicine and public health, and co-author.

The study emphasizes the need for public health awareness on the importance of the use of medications to treat patients with OUD. Researchers hope the data will inform public policy and regulations at the local, state, and federal level.

“Medications prevent overdoses and ultimately save lives. So it follows that we should continue to pursue efforts to reduce barriers to accessing them,” adds William Becker, MD, professor of medicine.