Buprenorphine treatment gaps raise overdose risk sharply. In a new study, patients whose buprenorphine treatment for opioid use disorder was interrupted were almost three times more likely to overdose than patients who stayed on it. Any gap in buprenorphine treatment is a warning sign, not a minor lapse.
Summary: Opioid prescriptions are falling, yet overdoses are rising. Buprenorphine is one of the first and most effective drugs for opioid use disorder (OUD). Sadly, a new study shows that people with a gap in treatment are almost three times more likely to overdose on opioids. So skipping buprenorphine must be seen as a major red flag.
Opioid use may be falling, but opioid abuse is not. As pressure on doctors grows, they are more and more hesitant to prescribe opioids. But the data shows this did not cut opioid abuse and opioid overdose-related deaths. In fact, opioid overdose deaths in 2021 were almost 50% higher than in 2020, with more than 70,000 deaths.
So we still need to find the causes of opioid overdose. People with opioid addiction must get proper treatment. More must be done to prevent overdose deaths. One way is to spot the red flags and the people at greatest risk. Now the study shows that people who do not take buprenorphine medication regularly are much more likely to die of an overdose.
Buprenorphine is also an opioid, but a safer one, used to treat opioid use disorder (OUD). It is often given as part of opioid addiction treatment and works quite well. It was one of the first medicines approved for OUD. But results depend on how regularly a person takes any medicine. So sticking with it is key, and OUD treatment with buprenorphine is no exception.
The new study was published in JAMA Psychiatry, one of the most respected journals. Researchers looked at data from 34,505 patients getting buprenorphine medication through Medicare. The treatment gap was more common in young men and in people with disabilities. More important, the risk of opioid overdose in these people was 2.89 times higher than in patients with no treatment gap.
A nearly threefold difference in risk between groups is huge. It is vital to know. The study had other interesting findings. A treatment gap raised the risk 2.84 times in people prescribed 16 mg/day of buprenorphine. The risk was 3.62 times in those taking 8 mg/day or less. So the risk was higher in young patients and in those who had started treatment recently.
These findings matter in many ways. This is one of the few studies to find a major red flag for opioid overdose and related deaths. It shows an urgent need to help people stick with opioid addiction treatment.
Of course, sticking with treatment matters for any treatment. But no one imagined that skipping buprenorphine treatment might be tied to such a huge overdose risk.
These findings matter for both doctors and people with OUD. Patients need to know they are risking their lives by not following treatment. So avoid a casual approach, avoid seeking opioids, and stick with the treatment.
It is a wake-up call for doctors, health workers and policymakers to take opioid addiction treatment follow-through more seriously. The study makes clear that skipping treatment is one of the biggest overdose risk factors. Luckily, spotting skipped treatment is often easy, above all with electronic health records. So steps must be taken to find these patients and give them closer care to prevent tragedies.
Frequently asked questions
What happens if you stop taking buprenorphine?
A gap in buprenorphine treatment sharply raises the risk of overdose. A study in JAMA Psychiatry followed 34,505 Medicare patients taking buprenorphine for opioid use disorder. Those with a treatment gap were 2.89 times more likely to overdose than patients who stayed on treatment. Missing buprenorphine is not a small slip. It is one of the biggest overdose red flags there is.
Is buprenorphine an opioid?
Yes. Buprenorphine is an opioid, but a safer one used to treat opioid use disorder (OUD). It was one of the first medicines approved for OUD and is often part of opioid addiction treatment. Like any medicine, it only works when taken regularly. With buprenorphine, sticking to treatment is not just about results. It is about staying alive.
Who is most likely to have a gap in buprenorphine treatment?
In the study, treatment gaps were more common in young men and in people with disabilities. Risk was also higher in patients who had only recently started treatment. Doctors can usually spot a gap in the electronic health record. So these patients can be found and given closer care before a missed dose turns into an overdose.
Does the buprenorphine dose change overdose risk after a gap?
Yes. A treatment gap raised overdose risk 2.84 times in patients prescribed 16 mg of buprenorphine a day, and 3.62 times in those taking 8 mg a day or less. The risk ran highest in younger patients and in people who had not been on treatment for long. That is when steady daily use matters most.
Are opioid overdose deaths still rising?
Yes. Opioid prescriptions are falling, but overdoses are not. Opioid overdose deaths in 2021 were almost 50% higher than in 2020, with more than 70,000 lives lost. Cutting prescriptions did not cut addiction or deaths. That is why finding the people at greatest risk, including those with gaps in buprenorphine treatment, matters so much.
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