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Few Patients Receiving Buprenorphine Taper Off; Most of Those Who Do Return to Treatment

December 28, 2018 by ATForum

“Office-based buprenorphine is an effective treatment for opioid use disorder; the current standard of care is to continue it indefinitely. Some patients express a desire to eventually taper off; others experience external pressures to do so. However, data are scant on the frequency and success of tapering off. In this single-site, retrospective cohort study, researchers reviewed 12 years of office-based addiction treatment data including 1308 patients with a median follow-up of 316 days to determine the proportion who tapered off of buprenorphine, describe their characteristics, and determine the proportion that returned.

  • During the full follow-up period of 2361 days, 48 patients tapered off of buprenorphine. Using Kaplan-Meier proportion estimates, which account for censored participants (those lost to follow-up or at end of the study), 15% tapered off of buprenorphine.
  • Patients who underwent a supervised taper were engaged in treatment longer (median 774 days versus 433 days), had lower prescribed dosages (45% prescribed <4 mg/day versus 19%), and were more likely to be employed or a student (52% versus 24%), compared with those who underwent an unsupervised taper.
  • Most of the patients (61%) who tapered off of buprenorphine returned to treatment. Most of them (77%) had undergone an unsupervised taper.

Comments: This study shows that a small proportion of patients receiving buprenorphine taper off and most return to treatment. This supports treating opioid use disorder as a chronic condition and continuing with treatment indefinitely without placing arbitrary time limits or end-points.”

Jarratt Pytell, MD & Darius A. Rastegar, MD

Read more at: http://www.bu.edu/aodhealth/2018/12/11/few-patients-receiving-buprenorphine-taper-off-most-of-those-who-do-return-to-treatment/

Source: Alcohol, Drugs and Health: Current Evidence – November – December 2018

Filed Under: 2018, Medication-Assisted Treatment (MAT), News Updates

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