Williams AR, et al. - As most patients discontinue buprenorphine treatment within a few weeks or months despite its efficacy in reducing the risk of overdose and death in opioid use disorder, researchers here compared adverse health outcomes following buprenorphine discontinuation among patients who were successfully retained beyond 6 months of continuous treatment, a minimum treatment duration recently endorsed by the National Quality Forum. The MarketScan multistate Medicaid claims database (2013–2017) covering 12 million beneficiaries annually was used to perform this retrospective longitudinal cohort analysis. The sample comprised adults (18–64 years of age) who obtained buprenorphine continuously for ≥ 180 days by cohorts retained for 6–9 months, 9–12 months, 12–15 months, and 15–18 months. All cohorts commonly experienced adverse events, and almost half of the patients (42.1%−49.9%) were seen in the emergency department at least once. Significantly lower odds of emergency department visits, inpatient hospitalizations, and filling opioid prescriptions in the 6 months following discontinuation were reported among patients retained on buprenorphine for 15–18 months (N = 931) vs those retained for 6–9 months (N = 4,126). Across all cohorts, nearly 5% of patients experienced one or more medically treated overdoses. Findings suggest a high risk of using acute care service and overdose after buprenorphine discontinuation; this risk was observed irrespective of treatment duration. With treatment duration beyond 15 months, significant superior outcomes became evident, although rates of the primary adverse outcomes remained high.