Community Resource for Patients and Families: Buprenorphine (Maintenance)

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Adjunctive Counseling During Brief and Extended Buprenorphine-Nalaxone Treatment for Prescription opioid use disorder: A 2-Phase Randomized Controlled Trial

Category:  Buprenorphine (Maintenance)

Last Update:  04/13/14 (Dr. Maria Sullivan, MD, PhD and Danielle M. Simpson, MS II)

Findings:

When patients who have been opioid-dependent are transitioned to buprenorphine/naloxone (Suboxone) maintenance, they benefit most from long-term treatment.  Tapering off buprenorphine/naloxone, even after 12 weeks, is associated with relapse to opioid use disorder. These outcomes are similar for patients with or without chronic pain.

This large study (N=653) examined the effectiveness of different lengths of buprenorphine/naloxone treatment for patients dependent on prescription opioids.  All participants were offered buprenorphine-naloxone maintenance. Some patients were randomized to receive relapse prevention counseling in addition to medication.  This study found that individuals with or without chronic pain were most successful in abstaining from opioid use while continuing to take buprenorphine-naltrexone, regardless of whether or not they received opioid use disorder counseling.  Relapse rates were much higher for patients who tapered off buprenorphine/naloxone than for those patients who continued medication-assisted treatment.

Reference:

Weiss RD, Potter JS, Fiellin DA, Byrne M, Connery HS, Dickinson W, Gardin J, Griffin ML, Gourevitch MN, Haller DL, Hasson AL, Huang Z, Jacobs P, Kosinski AS, Lindblad R, McCance-Katz EF, Provost SE, Selzer J, Somoza EC, Sonne SC, Ling W. (2011). Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid use disorder: a 2-phase randomized controlled trial.  Arch Gen Psychiatry, Dec;68(12):1238-46.