Survival After Hospitalization in Patients with Opioid Use Disorder: Impact of Medications for Opioid Use Disorder

Objective We investigated whether providing medications for opioid use disorder (MOUD) during hospitalization is associated with reduced all-cause post-discharge mortality.Methods We conducted a retrospective cohort study of hospital admissions for patients with OUD at a large, urban hospital in 2023. Cohorts were admissions in which patients received MOUD versus those who were not offered MOUD. Primary outcome was post-discharge all-cause mortality at 30 and 90 days. Time to mortality was modeled using Cox regression with robust standard errors to account for patient characteristics and readmissions. Secondary outcome was drug overdose mortality within 90 days.Results In unadjusted analysis, 30-day mortality was lower for encounters in which MOUD was provided (1.8% vs 4.4%, OR 0.39, 95% CI 0.17–0.92, p = 0.028) but not at 90 days (6.0% vs 8.2%, OR 0.71, 95% CI 0.40–1.27, p = 0.238). An adjusted Cox proportional hazards model demonstrated that MOUD was associated with reduced mortality at 30 days (HR 0.27, 95% CI 0.11–0.70, p = 0.005) but not at 90 days (HR 0.55, 95% CI 0.30–1.00, p = 0.051). Drug overdose mortality within 90 days of discharge was 0.4% in encounters in which patients were provided MOUD, versus 3.9% for those who were not offered MOUD (OR 0.10, 95% CI 0.02–0.50, p < 0.001).Conclusion MOUD was associated with lower post-discharge all-cause mortality at 30 days, but not at 90 days. MOUD was associated with lower risk of overdose death at 90 days.