New Study Suggests Higher Doses of Buprenorphine Improve Retention in Opioid Addiction Treatment
A recent study funded by the National Institute on Drug Abuse (NIDA) has found that higher doses of buprenorphine, a medication used to treat opioid use disorder, can improve retention in treatment. The study, conducted by researchers at Brown University, NIDA, and the Rhode Island Department of Health, analyzed patients prescribed buprenorphine in Rhode Island from 2016 to 2020 during the emergence of fentanyl.
Fentanyl, a synthetic opioid that is 50 times stronger than heroin, has been a primary contributor to the alarming number of overdose deaths in the United States. In 2021 alone, over 70,000 overdose deaths were primarily due to fentanyl. This has raised concerns about existing dosing guidelines for buprenorphine and whether they should be modified.
The study examined data from 6,499 Rhode Island residents initiating buprenorphine treatment for opioid use disorder. It found that patients prescribed a higher dose of buprenorphine were retained in treatment for a longer period. Those prescribed a lower dose were 20% more likely to discontinue treatment compared to those on a higher dose.
Currently, the U.S. Food and Drug Administration recommends a daily dose of 16 milligrams of buprenorphine for most patients. However, this study suggests that higher doses, up to 24 mg, may be more effective, particularly for individuals with higher levels of tolerance to and dependence on opioids.
The results of this study highlight the need to reevaluate clinical guidelines for opioid addiction treatment in order to optimize treatment and help people achieve recovery. As a result, scientists plan to conduct a prospective randomized clinical trial to further explore the impact of daily buprenorphine doses up to 24 mg on treatment retention and reducing overdose risk.
The trial will also investigate other factors associated with treatment retention, including clinician prescribing practices and patient socio-demographics. The findings from this trial could potentially inform updates to opioid use disorder treatment standards.
For individuals seeking information on substance and mental health treatment programs, the National Helpline at 1-800-662-HELP (4357) is available. Additionally, they can visit www.FindTreatment.gov for more resources.
The National Institute on Drug Abuse (NIDA), which funded this study, is part of the National Institutes of Health (NIH). The NIH is the primary federal agency conducting and supporting medical research, seeking to understand and find cures for both common and rare diseases. Through initiatives like this, NIDA aims to address the health aspects of drug use and addiction.
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