Using a large national cohort of commercial insurance and Medicaid enrollees, we evaluated the association between polysubstance use with buprenorphine and naltrexone use in individuals with a primary diagnosis of OUD. Among individuals receiving buprenorphine or naltrexone, we examined the association of buprenorphine and naltrexone use with nonfatal drug-related poisonings in individuals with OUD and polysubstance use.