Buprenorphine maintenance therapy is more effective than detoxification for patients being treated for prescription opioid dependence, a new study finds.
The researchers, from Yale University, said primary care doctors do not have evidence-based guidelines to decide between the two treatments.
The researchers conducting the 14-week study followed 113 patients with prescription opioid dependence, Health Canal reports.
The patients in the detox group received six weeks of stable doses of buprenorphine followed by three weeks of tapering doses, while patients in the maintenance group received ongoing buprenorphine therapy. All patients received physician and nurse support and drug counseling for 14 weeks.
Patients in the detox group tested positive for illicit opioid use more frequently than those in the buprenorphine maintenance group, lead researcher Dr. David Fiellin reported in JAMA Internal Medicine. Maintenance group members were also less likely to use illicit opioids. Few patients in the detox group stayed in treatment or were able to abstain from using opioids after they stopped taking buprenorphine.
"For prescription opioid dependence, buprenorphine detoxification is less effective than ongoing maintenance treatment, and increases the risk of overdose and other adverse events," Fiellin said in a news release.
"It is very common for patients seeking treatment to request detoxification," he added. "They want to be off of everything as soon as possible as opposed to considering long-term treatment, but unfortunately there's no quick fix for the disease. The majority of patients will do better if they receive ongoing maintenance treatment."