Why We Fail to Maximize the Benefits of Methadone and Buprenorphine
Submission Date: May 7, 2019
Attributing Author: Alison Knopf
“The bottom line, for Snodgrass, is that providers should not ignore the potential benefits of higher buprenorphine doses. “When you see a study reporting low retention rates for buprenorphine, ascertain the dose used in the study,” he urged. “I think you will find the dose used was 16 mg or less.”
As we learn more about buprenorphine, a point on which we should all agree is that adequate doses of the medication must be given if we’re serious about cutting overdose deaths. We already know enough about methadone: Doses can be adequate for all patients.
Medication for anything only works if the patient takes enough. This is emphatically true for people taking medications for opioid use disorder. If they don’t get enough buprenorphine or methadone, they are likely to experience cravings and revert to using risky, often dangerously adulterated opioids.
Yet far too often—thanks to undue fears and stigma, misinterpretation of evidence and misguided regulations—buprenorphine is prescribed at inadequate doses while the advantages of methadone are under-utilized.
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