Higher buprenorphine doses linked to improved retention in treatment for opioid use disorder

Individuals with opioid use disorder who were prescribed a lower buprenorphine dose were 20% more likely to discontinue treatment than those on a higher dose, according to a study of patients prescribed buprenorphine in Rhode Island from 2016 to 2020, as fentanyl became widely available.

In this study, researchers retrospectively examined data from a statewide population of 6,499 Rhode Island residents initiating buprenorphine as part of treatment for opioid use disorder from 2016 to 2020, a period of fentanyl emergence and predominance. The goal was to estimate the association between patients’ daily buprenorphine dose and retention in treatment over 180 days. At the initiation of buprenorphine treatment, approximately 21% (1,343 patients) were prescribed 8 mg, 50% (3,264 patients) 16 mg, and 10% (668 patients) 24 mg.

Patients prescribed a 24 mg dose of buprenorphine were retained in treatment for a longer period than those prescribed the recommended target maintenance dose of 16 mg. A statistical analysis showed the latter group was 20% more likely to discontinue treatment than those prescribed 24 mg.

The findings suggested that a higher buprenorphine dose – up to 24 mg – may help improve treatment retention for these individuals.

Reference: LC Chambers, et al. Buprenorphine Dose and Time to Discontinuation Among Patients with Opioid Use Disorder in the Era of Fentanyl. JAMA Network Open. DOI: 10.1001/jamanetworkopen.2023.34540 (2023)