Higher buprenorphine doses associated with improved retention in treatment for OUD

A new study in JAMA Network Open found that people with OUD who were prescribed a lower dose of buprenorphine were 20% more likely to discontinue treatment compared with those receiving a higher dose.

According to FDA, the recommended target dosage of buprenorphine for treating OUD is 16 mg per day.

In the retrospective study, researchers evaluated data from 6,499 Rhode Island residents who started using buprenorphine to treat OUD from 2016 to 2020. About 21% of patients (1,343) were prescribed 8 mg per day, 50% (3,264) were prescribed 16 mg per day, and 10% (668) received 24 mg per day.

Individuals who were prescribed the 24-mg dose of buprenorphine stayed in treatment for a longer length of time compared with those who received 16 mg. A statistical evaluation revealed that those individuals who were prescribed 16 mg were 20% more likely to stop treatment than those prescribed 24 mg.

“The current recommended target dose of buprenorphine was derived from studies conducted prior to the widespread availability of fentanyl. Now, we’re seeing people with higher levels of tolerance to and dependence on opioids, and our findings suggest that a higher buprenorphine dose—up to 24 mg—may help improve treatment retention for these individuals,” said Rachel Wightman, MD, one of the principal investigators of the study, in a news release. “We have a responsibility to set patients up for success.”