Higher Buprenorphine Doses Needed to Combat Fentanyl

The U.S. Department of Health & Human Services, National Institutes of Health released a press release dated September 18, 2023, detailing a study that suggests that higher buprenorphine doses are associated with improved retention in treatment for opioid use disorder.

According to the US Substance Abuse and Mental Health Services Administration, “Buprenorphine is the first medication to treat opioid use disorder (OUD) that can be prescribed or dispensed in physician offices, significantly increasing access to treatment.”

They added, “As with all medications used in treatment, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other services to provide patients with a whole-person approach.”

The study found that patients who were prescribed a lower buprenorphine dose were 20% more likely to discontinue treatment than those on a higher dose. The study, which took place in Rhode Island 2016 to 2020, was published in JAMA Network Open.

The study is important as it adds evidence to the discussion of how to effectively treat substance use disorder in the age fentanyl, a synthetic opioid that is approximately 50 times stronger than heroin. In 2021 alone, more than 70,000 of 107,000 reported overdose deaths were primarily due to fentanyl. The overwhelming presence of fentanyl in the drug supply and associated increase in overdose deaths has healthcare professionals asking if the existing dosing guidelines for buprenorphine should be increased to address fentanyl use.

The study found that, “A statistical analysis that allowed for multivariable comparison of these two dose groups showed patients prescribed the recommended dose (16 mg) were significantly more likely to discontinue treatment over 180 days compared to those prescribed 24 mg.”

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