Bahji A, et al. - Via performing a systematic review and meta-analysis, researchers examined how methadone or buprenorphine is associated with cause-specific mortality among opioid-dependent persons. Searching six online databases, they included 32 eligible cohort studies, representing 150,235 participants, 805,423.6 person-years, and 9,112 deaths. They identified substantially higher crude mortality rates among methadone cohorts vs buprenorphine cohorts. Methadone relative to buprenorphine led to substantially higher relative risk reduction when time in-treatment was compared with time out-of-treatment. Furthermore, the first 4 weeks of treatment displayed the greatest mortality reduction. Mortality measures were substantially heterogeneous and were significantly variable by country, region, and by the nature of the treatment provider. Findings emphasize practicing caution for the safer implementation of opioid agonist therapy, including baseline evaluations of opioid tolerance, ongoing monitoring during the induction period, education of patients about the risk of overdose, and coordination within healthcare services.