Buprenorphine-Naloxone Works for Prescription Opioid Dependence As Long As It Is Maintained
This 2-phase multisite randomized clinical trial examined the effectiveness of buprenorphine-naloxone (BUP/NX) treatment among 653 patients with prescription opioid dependence and assessed whether intensive counseling provided any additional benefit. Poor response* to brief treatment in Phase 1 (2-week BUP/NX stabilization followed by 2-week taper and 8-week postmedication follow-up) determined whether patients would continue on to receive extended treatment in Phase 2 (12-week BUP/NX stabilization followed by 4-week taper and 8-week follow-up). In each phase, patients were randomized to either standard medical management (SSM) (15–20 minute visits with a physician certified to prescribe BUP/NX) or SSM plus intensive opioid-dependence counseling (45–60 minute sessions with a trained mental-health professional).
- Only 6.6% of patients were opioid-free after brief BUP/NX treatment, with no improvement added by intensive drug counseling.
- Forty-nine percent of patients were opioid-free after extended BUP/NX treatment, but 8 weeks after the taper, this rate dropped to 8.6%, again with no improvement added by intensive drug counseling.