Boulder Care

Common Myths about Buprenorphine

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Adapted from Martin, Chiodo, Bosse, & Wilson, 2018 [1]

MYTH: Buprenorphine and buprenorphine/naloxone are only supposed to be taken for a short time.

FACT: Opioid use disorder (OUD) is a chronic condition that people will have for their entire lives. People who take buprenorphine for longer periods of time have better treatment outcomes than people who only take buprenorphine for a shorter time [2, 3]. The Substance Abuse and Mental Health Services Administration (2018) advocates that clinicians should work closely with people to individualize treatment and that people should be able to keep taking buprenorphine as long as it is helpful to them [4]. That’s the approach we take at Boulder Care.

MYTH: If someone is still using opioids or other substances while taking buprenorphine, it means buprenorphine is not working for them.

FACT: There are all kinds of reasons someone might be struggling with uncontrolled use of substances. There are also people who may want to reduce their use but not stop. People who continue to use opioids or other substances while in treatment may need more support, not less. This could mean more frequent visits with their care team, a higher dose of medication, and/or connecting with other services.

It is also important to remember that buprenorphine is meant to treat only OUD. We cannot expect it to treat other substances like cocaine, alcohol, or methamphetamines.

MYTH: If people are taking buprenorphine, they also need to be in counseling.

FACT: Counseling is helpful for some people, but not everyone. Other people might want peer support or other types of social support. At Boulder, we are committed to delivering treatment that is based on evidence. There is not enough scientific evidence to require counseling [5, 6, 7, 8].

At Boulder, we don’t take a “one size fits all” approach to treatment plans. We want people to take part in only the types of treatment they find helpful and their entire care team will work to connect them with any services that we can’t provide.

Resources

References

  1. Martin SA, Chiodo LM, Bosse JD, Wilson A. The Next Stage of Buprenorphine Care for Opioid Use Disorder. Ann Intern Med. 2018;169(9):628. doi:10.7326/M18-1652
  2. Caldiero RM, Parran TVJ, Adelman CL, Piche B. Inpatient Initiation of Buprenorphine Maintenance vs Detoxification: Can Retention of Opioid-Dependent Patients in Outpatient Counseling Be Improved? Am J Addict. 2006;15(1):1-7. doi:10.1080/10550490500418989
  3. GE W, SA P, Subramaniam G, et al. Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth: a randomized trial. JAMA J Am Med Assoc. 2008;300(17):2003-2011. doi:10.1001/jama.2008.574
  4. Substance Abuse and Mental Health Services Administration. TIP 63: Medications for Opioid Use Disorders – Full Document (Including Executive Summary and Parts 1-5).
  5. Clark RE, Baxter JD, Aweh G, O’Connell E, Fisher WH, Barton BA. Risk Factors for Relapse and Higher Costs Among Medicaid Members with Opioid Dependence or Abuse: Opioid Agonists, Comorbidities, and Treatment History. J Subst Abuse Treat. 2015;57:75-80. doi:10.1016/j.jsat.2015.05.001
  6. Weiss AJ, Elixhauster A, Barrett ML, Steiner CA, Baily MK, O’Malley L. Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-2014 #219. Rockville, MD; 2017.
  7. Fiellin D, MV P, MC C, et al. Counseling plus buprenorphine-naloxone maintenance therapy for opioid dependence. N Engl J Med. 2006;355:365-374. doi:10.1056/NEJMoa055255
  8. Friedmann P, Schwartz R. Just call it “treatment.” Addict Sci Clin Pract. 2012;7(10). doi:10.1186/1940-0640-7-10

Questions, concerns, or feedback?

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