Commentary on D'Agata Mount et al.: Higher dose buprenorphine to improve retention in opioid use disorder treatment, prevent relapse, and optimize integrated care interventions

Abstract

Using buprenorphine doses higher than currently recommended by opioid use disorder guidelines is effective, it may help distinguish triggers of relapse and differentiate the role of pharmacologic and socio-environmental interventions. This choice can increase acceptability among patients and providers, and validate the practice in community services, starting with primary care. D'Agata Mount et al.[1] offer convincing proofs of the superiority of 32 mg/day buprenorphine for the low-threshold treatment of opioid use disorder (OUD), despite a non-randomized uncontrolled design. The study is a retrospective longitudinal observation and provides within group and between group comparisons with the 24 mg/ day dose, identifying strong differences in a relatively small sample.