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• W2022774038 startingPage "48" @default.
• W2022774038 abstract "Buprenorphine maintenance therapy (BMT) is increasingly the preferred opioid maintenance agent due to its reduced toxicity and availability in an office-based setting in the United States. Although BMT has been shown to be highly efficacious, it is often discontinued soon after initiation. No current systematic review has yet investigated providers' or patients' reasons for BMT discontinuation or the outcomes that follow. Hence, provider and patient perspectives associated with BMT discontinuation after a period of stable buprenorphine maintenance and the resultant outcomes were systematically reviewed with specific emphasis on pre-buprenorphine-taper parameters predictive of relapse following BMT discontinuation. Few identified studies address provider or patient perspectives associated with buprenorphine discontinuation. Within the studies reviewed providers with residency training in BMT were more likely to favor long term BMT instead of detoxification, and providers were likely to consider BMT discontinuation in the face of medication misuse. Patients often desired to remain on BMT because of fear of relapse to illicit opioid use if they were to discontinue BMT. The majority of patients who discontinued BMT did so involuntarily, often due to failure to follow strict program requirements, and 1 month following discontinuation, rates of relapse to illicit opioid use exceeded 50% in every study reviewed. Only lower buprenorphine maintenance dose, which may be a marker for attenuated addiction severity, predicted better outcomes across studies. Relaxed BMT program requirements and frequent counsel on the high probability of relapse if BMT is discontinued may improve retention in treatment and prevent the relapse to illicit opioid use that is likely to follow BMT discontinuation." @default.
• W2022774038 created "2016-06-24" @default.
• W2022774038 creator A5000157775 @default.
• W2022774038 creator A5004307918 @default.
• W2022774038 creator A5060469019 @default.
• W2022774038 creator A5083001883 @default.
• W2022774038 date "2015-05-01" @default.
• W2022774038 modified "2023-10-15" @default.
• W2022774038 title "Discontinuation of Buprenorphine Maintenance Therapy: Perspectives and Outcomes" @default.
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• W2022774038 doi "https://doi.org/10.1016/j.jsat.2014.12.011" @default.
• W2022774038 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/4382404" @default.
• W2022774038 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/25601365" @default.
• W2022774038 hasPublicationYear "2015" @default.
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