Treatment Outcomes in a Specialized Opioid Maintenance Program for Prescription Opioid Use Disorder in Israel

A rapid increase in opioid prescriptions necessitated the implementation of a specific opioid maintenance treatment arm in the Methadone Maintenance Treatment clinic for opioid use disorder (OUD).

To characterize patients referred to this arm, those who initiated treatment and their outcomes.

Individuals referred between November/2019 and June/2025 were included. Patient characteristics, retention, and drug abstinence were studied.

Of 184 referrals, 54 (29.3%) were admitted. They had a higher female proportion (50% vs. 32.3%, p=0.03) and more years of education (13.1±3.4 vs. 11.2±3.8, p=0.008) than those not admitted, with no significant age difference (50.5±15.8 vs. 52.0±16.4, p=0.6). Of the 54 admitted patients, 5 were transferred to the "regular" OUD arm. Of the remaining 49, 18.4% were treated with methadone and 40 with oral buprenorphine (21 switched later to a once-monthly injectable formulation). Overall, 42.9% used fentanyl: 44.4% of those on methadone, 42.1% on buprenorphine, and 42.9% on the injectable formulation. Ninety (51.4%) stayed one year; of them, 88.9% stopped prescription opioids. Cumulative retention was longer among females (2.3y, 95% CI: 1.8-2.9) than males (1.2y, 95% CI: 0.8-1.6, p=0.046). Retention among those treated with injectable buprenorphine (2.4y, 95% CI: 1.8-3.0) or methadone (1.7y, 95% CI: 0.9-2.4) was comparable, and both were longer than with oral buprenorphine (0.7y, 95% CI: 0.4-1.0, p<0.001 and p=0.039, respectively).

Positive treatment outcomes were observed in this specific population, particularly among those treated with methadone or injectable buprenorphine, but future follow-up and a larger sample are needed. Physicians' education is necessary to achieve more accurate referrals.