Condition

Opioid use disorders

Clinical trials and treatment information for Opioid use disorders

16.2M
People Affected
80
Active Trials
647K
New Cases/Year
100K
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Methadone
88% Effectiveness• 98% Confidence• 50% Safety• 124 trials• 200K participants
HIGH EvidenceExcellent ValueDose: 60-120 mg daily, orally, in a supervised clinic
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
50
DangerousModerateSafe

Time to Effect

Immediate (stabilization 1-2 weeks)

Duration

Lifetime

Response Rate

75%

Remission Rate

50%

Number Needed to Treat (NNT)

3

Number Needed to Harm (NNH)

80

Common Side Effects:

Constipation: 30%
Sweating: 30%
Drowsiness: 20%
Nausea/Vomiting: 10%
QT prolongation/cardiac effects (rare but serious): 1%
Respiratory depression: 5%

Annual Cost of Care

Drug Cost

$240

Monitoring

$6,500

Side Effects

$100

Total Annual

$6,840

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.45

ICER

$40,000/QALY

Cost per Remission

$13,680

Cost per Responder

$9,120

Treatment Outcomes
Primary Outcomes
Opioid-positive Urine Drug Screens75% of weeks
-60% (Reduction from 75% to 30% of weeks)
Treatment Retention at 12 months30% (without MOUD)
+100% (Increase from 30% to 60%)
Opioid Craving Score (0-10 Visual Analog Scale)7.5/10
-47% (Reduction by 3.5 points on 0-10 VAS)
Opioid-related Arrests0.8 arrests/year
-62.5% (Reduction by 0.5 arrests/year)
Secondary Benefits
Injecting Drug Use Frequency5 days/week
-80% (Reduction by 4 days/week)
Quality of Life Score (0-100 scale, higher is better)45/100
+33.3% (Increase by 15 points on 0-100 scale)
Full-time Employment Rate25% of patients
+100% (Increase from 25% to 50% of patients)
Common Side Effects
Constipation
+30%
Sweating
+30%
Drowsiness
+20%

Clinical Trial Phases:

Phase 4
2
Buprenorphine/Naloxone
85% Effectiveness• 95% Confidence• 58% Safety• 115 trials• 50K participants
HIGH EvidenceGood ValueDose: 8-24 mg/day of buprenorphine equivalent
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
58
DangerousModerateSafe

Time to Effect

Immediate (after induction)

Duration

Lifetime

Response Rate

65%

Remission Rate

40%

Number Needed to Treat (NNT)

4

Number Needed to Harm (NNH)

75

Common Side Effects:

Headache: 30%
Nausea: 15%
Constipation: 20%
Sweating: 10%
Drowsiness: 10%

Annual Cost of Care

Drug Cost

$2,400

Monitoring

$3,600

Side Effects

$100

Total Annual

$6,100

Cost-Effectiveness

GOOD

QALYs Gained

0.4

ICER

$55,000/QALY

Cost per Remission

$15,250

Cost per Responder

$9,384.62

Treatment Outcomes
Primary Outcomes
Illicit Opioid-Positive Urine Drug Screens75% of screens positive
-80% (-60 percentage points)
Opioid Craving ScoreOpioid Craving Scale (0-10): 7/10
-71.4% (-5 points)
Opioid Withdrawal SeverityCOWS score (0-48): 25/48
-80% (-20 points)
Secondary Benefits
Quality of LifeQ-LES-Q-SF score (14-70): 45/70
+44.4% (+20 points)
Depressive SymptomsPHQ-9 score (0-27): 18/27
-55.6% (-10 points)
Global Assessment of Functioning (GAF) ScoreGAF score (0-100): 40/100
+50% (+20 points)
Common Side Effects
Headache
+30%
Nausea
+15%
Constipation
+20%

Clinical Trial Phases:

Phase 3Phase 4
3
Naltrexone (Extended-Release Injectable)
80% Effectiveness• 90% Confidence• 68% Safety• 16 trials• 10K participants
HIGH EvidenceModerate ValueDose: 380 mg intramuscular injection once monthly
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
68
DangerousModerateSafe

Time to Effect

Within hours of injection (lasts 1 month)

Duration

Monthly injections for at least 12 months

Response Rate

55%

Remission Rate

30%

Number Needed to Treat (NNT)

7

Number Needed to Harm (NNH)

100

Common Side Effects:

Nausea: 15%
Headache: 15%
Injection site pain/tenderness: 40%
Fatigue: 10%
Hepatotoxicity: 1%

Annual Cost of Care

Drug Cost

$16,800

Monitoring

$3,000

Side Effects

$100

Total Annual

$19,900

Cost-Effectiveness

MODERATE

QALYs Gained

0.35

ICER

$90,000/QALY

Cost per Remission

$66,333.33

Cost per Responder

$36,181.82

Treatment Outcomes
Primary Outcomes
Opioid-Positive Urine Drug Screens75% positive
-60% (-45 percentage points)
Relapse to Opioid Dependence60% of participants relapse within 6 months
-67% (-40 percentage points)
Opioid Craving (VAS)65/100 mm
-54% (-35 mm)
Treatment Retention8 weeks (median)
+125% (+10 weeks (median))
Secondary Benefits
SF-36 Physical Component Summary (PCS)40 points (population norm 50)
+20% (+8 points)
Beck Depression Inventory-II (BDI-II)25/63 points (moderate depression)
-40% (-10 points)
Employment Rate30% employed
+66.7% (+20 percentage points)
Common Side Effects
Nausea
+15%
Headache
+15%
Injection site pain/tenderness
+40%

Clinical Trial Phases:

Phase 3Phase 4
4
Psychosocial Support & Counseling (e.g., CBT, Contingency Management)
70% Effectiveness• 85% Confidence• 95% Safety• 400 trials• 60K participants
HIGH EvidenceGood ValueDose: 1-3 sessions per week, 30-90 minutes per session
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

Weeks to months

Duration

Weeks to years, often ongoing

Response Rate

45%

Remission Rate

15%

Number Needed to Treat (NNT)

10

Common Side Effects:

Emotional distress during sessions: 10%
Time commitment: 100%

Annual Cost of Care

Drug Cost

$0

Monitoring

$9,360

Side Effects

$0

Total Annual

$9,360

Cost-Effectiveness

GOOD

QALYs Gained

0.15

Cost per Remission

$62,400

Cost per Responder

$20,800

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+70%
Response Rate
+45%
Remission Rate
+15%
Common Side Effects
Emotional distress during sessions
+10%
Time commitment
+100%

Clinical Trial Phases:

Phase 4
5
Naltrexone (Oral)
65% Effectiveness• 80% Confidence• 70% Safety• 16 trials• 5K participants
MODERATE EvidenceModerate ValueDose: 50 mg orally once daily
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

Within hours (daily dosing)

Duration

Daily for at least 12 months

Response Rate

35%

Remission Rate

15%

Number Needed to Treat (NNT)

12

Number Needed to Harm (NNH)

120

Common Side Effects:

Nausea: 20%
Headache: 15%
Fatigue: 10%
Hepatotoxicity: 1%

Annual Cost of Care

Drug Cost

$480

Monitoring

$2,100

Side Effects

$50

Total Annual

$2,630

Cost-Effectiveness

MODERATE

QALYs Gained

0.15

ICER

$150,000/QALY

Cost per Remission

$17,533.33

Cost per Responder

$7,514.29

Treatment Outcomes
Primary Outcomes
Opioid Craving Score (OCQ)35/50
-30% (-10.5 points)
Opioid Use Days per Month18 days/month
-60% (-10.8 days/month)
Opioid-Positive Urine Drug Screens70% of tests positive
-50% (-35 percentage points)
Secondary Benefits
Treatment Retention Rate (at 12 weeks)30%
+50% (+15 percentage points)
Quality of Life Score (SF-36 total)60/100
+10% (+6 points)
Frequency of Risky Injection Practices3 times/week
-50% (-1.5 times/week)
Common Side Effects
Nausea
+20%
Headache
+15%
Fatigue
+10%

Clinical Trial Phases:

Phase 3Phase 4