Higher doses of buprenorphine for opioid use disorder could lower risks of emergency department visits or use of behavioral health services, a recent study found.
The study, published Sept. 25 in JAMA Network Open, analyzed insurance claims data from more than 35,000 people who were diagnosed with opioid use disorder and used buprenorphine treatment between 2016 and 2021.
The recommended dose for buprenorphine is 16 milligrams per day. Among people who used buprenorphine, 12.5% experienced ED or inpatient behavioral health.
But researchers found patients who took higher daily doses (16 to 24 mg) took 20% longer to have an ED or inpatient visit within the first year of treatment, compared to those who had 8 to 16 mg a day. Those who took more than 24 mg of buprenorphine went 50% longer before an ED or inpatient visit.
"These findings build upon accumulating evidence of the safety and efficacy of higher doses of buprenorphine," a National Institutes of Health news release said. "Studies have shown that more than 16 mg of buprenorphine is safe and well tolerated in people with opioid use disorder in emergency department and outpatient treatment settings, and that higher buprenorphine doses are associated with improved retention in treatment for opioid use disorder."
AMA President-elect Bobby Mukkamala, MD, shared a statement with Becker's supporting the study findings.
"The findings support AMA policy calling for flexibility in buprenorphine dosing, allowing patients to receive doses exceeding FDA-approved limits when clinically recommended by their prescriber," Dr. Mukkamala said. "Policymakers must take note of these findings and the growing body of evidence that further affirm buprenorphine as a safe, effective and lifesaving tool in the fight against the illicit fentanyl overdose epidemic. It is also critically important for health insurance companies, Medicaid and Medicare to remove dosage caps for buprenorphine. The AMA strongly urges outdated policies be revised to ensure patients with OUD can access lifesaving, evidence-based care."