Objective:

To examine the real-world comparative effectiveness of medication for opioid use disorder (MOUD) and psychotherapy on remission outcomes in individuals with opioid dependence.

Key Findings:

• Buprenorphine (aHR = 2.33; 95% CI: 1.85–2.94) and methadone (aHR = 2.50; 95% CI: 2.05–3.04) were associated with higher remission rates compared to no treatment.
• Psychotherapy (30 min: aHR = 2.18; 45 min: aHR = 2.38) also showed significant remission benefits.
• The combination of buprenorphine + psychotherapy had the strongest effect on remission (aHR = 5.26; 95% CI: 2.68–10.32).
• Anxiety diagnoses and gabapentinoid prescriptions were positively associated with remission, while benzodiazepine co-prescription was negatively associated.

Interpretation:

Both pharmacologic and psychosocial interventions independently improve remission rates in OUD, with enhanced benefits when combined, highlighting the importance of integrated treatment approaches.

Limitations:

• The study is observational and may be subject to confounding factors that could influence the results.
• Findings may not be generalizable to populations outside the 18–45 age range or those with complex comorbidities.

Conclusion:

The study underscores the value of comprehensive, multimodal harm-reduction services in routine care and strongly supports policies for equitable access to MOUD and behavioral health services.