after therapy per 1,000 years. For buprenorphine, overdose deaths increased in the first four weeks after stopping therapy and the overall death rate was 32 in the first four weeks and 10.9 in the remaining time without therapy. There was no significant difference between the first four weeks of therapy and the remaining time in the recovery center.
Two independent reviewers performed data extraction and assessed the quality of the study. Death rates in and just after therapy were combined across methadone and buprenorphine by random-effects meta-analysis.
The combined trend examination showed that comprehensively caused mortality decreased strongly over the first month of methadone therapy and decreased steadily 14 days after therapy.
Death rates from overall causes continued stable during induction and during the remaining time on buprenorphine treatment. Overdose deaths evolved similarly.
The study found that the death risk among opioid users in therapy is less than a third of that expected in the absence of opioid therapy. Buprenorphine maintenance therapy is most likely effective in reducing death, but quantification of averted deaths requires further study.
