New buprenorphine study – more disappointing outcomes

~ Jason Schwartz
Choose you evidence carefully by rocket ship
Choose you evidence carefully by rocket ship

So . . . congress recently passed $1,000,000,000 to address the opioid crisis. Much of that money is expected to be spent on medication assisted treatment.

Buprenorphine has been the most frequently touted form of medication assisted treatment. I’ve reviewed the research here and found that it does not live up to the hype.

A new study of buprenorphine was just published. It looks at prescription opioid use during and after buprenorphine treatment.

What did they find?

For their study, Alexander and his colleagues examined pharmacy claims for more than 38,000 new buprenorphine users who filled prescriptions between 2006 and 2013 in 11 states. They looked at non-buprenorphine opioid prescriptions before, during, and after each patient’s first course of buprenorphine treatment, which typically lasted between one to six months. Even though there are no universally agreed-upon guidelines regarding the optimal length of treatment, most people discontinued buprenorphine within three months.

They found that 43 percent of patients who received buprenorphine filled an opioid prescription during treatment and 67 percent filled an opioid prescription during the 12 months following buprenorphine treatment. Most patients continued to receive similar amounts of opioids before and after buprenorphine treatment.

They described buprenorphine’s impact and retention like this:

Buprenorphine therapy was associated with modest declines in most measures of opioid use following the first treatment episode; however, only 33% of patients continued to fill prescriptions for buprenorphine after 3 months.

Families and people with opioid problems are NOT looking for modest declines in use and a 67% drop out rate within 3 months.

Published by Jason Schwartz

I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work. Views expressed here are my own. Keep in mind that the field, the contexts in which the field operates, and my views have changed over time.

2 thoughts on “New buprenorphine study – more disappointing outcomes”

  1. I wonder how many of these folks were going to support groups and WANTED to be clean. MAT may address the craving of the drug but NOT the ritual of “finding ways and means to get more”

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  2. At least these researchers are being a bit more up front about the reality of the research findings. In your previous review of buprenorphine studies what struck me was how poor results would often be spun to look better. There seems to be a bit of professional denial going on (or dishonesty).

    The other thing that you regularly, quite rightly, bring us back to is what families and drug-dependent people want from treatment. Something better than this I expect, though this is likely to be better than no treatment. What about getting and staying drug-free safely?

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