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. 2020 May 7;10(3):80-84.
doi: 10.9740/mhc.2020.05.080. eCollection 2020 May.

Relapse rates among veterans on maintenance doses of combination buprenorphine and naloxone for opioid use disorder

Katie J Binger, Elayne D Ansara, Talia M Miles, Samantha L Schulte

Relapse rates among veterans on maintenance doses of combination buprenorphine and naloxone for opioid use disorder

Katie J Binger et al. Ment Health Clin. .

Abstract

Introduction: Opioid use disorder (OUD) can cause significant morbidity and mortality with more than 115 people dying from an opioid overdose daily in the United States. Treatment with buprenorphine/naloxone (BUP/NAL) can be effective; however, there is conflicting evidence on the utility of higher doses in preventing relapse. This study was designed to assess BUP/NAL maintenance doses and the rate of relapse in veterans with OUD.

Methods: Patients diagnosed with OUD who received a prescription for BUP/NAL through the substance use disorder recovery program were retrospectively evaluated. Patients were categorized into 2 treatment groups: those prescribed ≤16 mg of BUP/NAL daily and those prescribed >16 mg of BUP/NAL daily. The primary outcome was to determine rates of relapse between maintenance doses of BUP/NAL. Secondary outcomes included evaluating the difference in rates of relapse between daily versus take-home dosing, tablets versus films, time to relapse, and use of illicit substances during treatment.

Results: Patients prescribed >16 mg of BUP/NAL daily had statistically significantly lower rates of relapse compared to patients prescribed ≤16 mg of BUP/NAL daily (P = .0018). Regarding secondary outcomes, there was a statistically significant difference in time to relapse (P = .036) and dosage form (P = .0124). Difference in administration of dose and illicit substance use during treatment were not statistically significant.

Discussion: This study identified that rate of relapse can be lowered and time to relapse can be lengthened when doses >16 mg of BUP/NAL are prescribed in the veteran population for OUD.

Keywords: buprenorphine/naloxone; opioid use disorder; relapse rates; veterans.

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Conflict of interest statement

Disclosures: The authors of this study have no real or potential conflicts of interest to disclose.

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