Trends in buprenorphine dosage and days supplied for new treatment episodes for opioid use disorder, 2010-2019.
Buprenorphine
Opioid use disorder
Treatment retention
Journal
Drug and alcohol dependence
ISSN: 1879-0046
Titre abrégé: Drug Alcohol Depend
Pays: Ireland
ID NLM: 7513587
Informations de publication
Date de publication:
01 11 2023
01 11 2023
Historique:
received:
26
06
2023
revised:
19
09
2023
accepted:
20
09
2023
medline:
30
10
2023
pubmed:
16
10
2023
entrez:
15
10
2023
Statut:
ppublish
Résumé
Buprenorphine reduces risk of opioid overdose mortality. However, its benefits are limited by low retention, particularly in early treatment. Optimizing initial dosage may impact retention. However, little is known about the prescription characteristics of new buprenorphine treatment episodes. In a US sample of commercial and employer-sponsored pharmacy claims, we identified new buprenorphine treatment episodes (days 1-30) from individuals ≥16 years following 90 days without buprenorphine from 2010 to 2019. Outcomes included first prescription average days supplied, first prescription average daily dosage, and average dosage on days 2, 8, 15 and 30. We identified 117,793 new episodes among 96,451 unique individuals. Episodes per 10,000 person-years decreased slightly over time. Stratifying by age, sex and region demonstrated decreasing episodes among individuals ≤34 years and increasing episodes among individuals ≥35 years. From 2010-2019, first prescription average days supplied and daily dosage decreased from 17.1 to 15.3 days and 13.6mg to 11.6mg, respectively. Simultaneously, the proportion of episodes without possession and with dosages <16mg increased across all days and years. By day 30, episodes without buprenorphine possession grew from 27.9% to 30.8% and episodes involving dosages of <16mg grew from 26.4% to 33.4%. We found that buprenorphine dosage and days supplied for new treatment episodes decreased from 2010 to 2019 while buprenorphine possession worsened. Further investigation examining the relationship between buprenorphine dosage and retention in the early treatment period is needed.
Sections du résumé
BACKGROUND
Buprenorphine reduces risk of opioid overdose mortality. However, its benefits are limited by low retention, particularly in early treatment. Optimizing initial dosage may impact retention. However, little is known about the prescription characteristics of new buprenorphine treatment episodes.
METHODS
In a US sample of commercial and employer-sponsored pharmacy claims, we identified new buprenorphine treatment episodes (days 1-30) from individuals ≥16 years following 90 days without buprenorphine from 2010 to 2019. Outcomes included first prescription average days supplied, first prescription average daily dosage, and average dosage on days 2, 8, 15 and 30.
RESULTS
We identified 117,793 new episodes among 96,451 unique individuals. Episodes per 10,000 person-years decreased slightly over time. Stratifying by age, sex and region demonstrated decreasing episodes among individuals ≤34 years and increasing episodes among individuals ≥35 years. From 2010-2019, first prescription average days supplied and daily dosage decreased from 17.1 to 15.3 days and 13.6mg to 11.6mg, respectively. Simultaneously, the proportion of episodes without possession and with dosages <16mg increased across all days and years. By day 30, episodes without buprenorphine possession grew from 27.9% to 30.8% and episodes involving dosages of <16mg grew from 26.4% to 33.4%.
CONCLUSIONS
We found that buprenorphine dosage and days supplied for new treatment episodes decreased from 2010 to 2019 while buprenorphine possession worsened. Further investigation examining the relationship between buprenorphine dosage and retention in the early treatment period is needed.
Identifiants
pubmed: 37839942
pii: S0376-8716(23)01219-X
doi: 10.1016/j.drugalcdep.2023.110981
pmc: PMC10615721
mid: NIHMS1932796
pii:
doi:
Substances chimiques
Buprenorphine
40D3SCR4GZ
Analgesics, Opioid
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
110981Subventions
Organisme : NIDA NIH HHS
ID : K08 DA058052
Pays : United States
Informations de copyright
Copyright © 2023. Published by Elsevier B.V.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.
Références
Addiction. 1998 Apr;93(4):475-86
pubmed: 9684386
Subst Abus. 2022 Dec;43(1):1057-1071
pubmed: 35442178
J Subst Abuse Treat. 2018 Feb;85:90-96
pubmed: 28733097
Addiction. 2014 Dec;109(12):1957-8
pubmed: 24965487
Clin Pharmacol Ther. 2004 Jan;75(1):34-48
pubmed: 14749690
J Subst Abuse Treat. 2002 Dec;23(4):415-7
pubmed: 12495804
JAMA. 2023 Apr 25;329(16):1402-1404
pubmed: 37097363
Am J Psychiatry. 2005 Feb;162(2):340-9
pubmed: 15677600
J Subst Abuse Treat. 2019 Oct;105:37-43
pubmed: 31443889
Cochrane Database Syst Rev. 2004;(3):CD002207
pubmed: 15266465
J Addict Med. 2015 Nov-Dec;9(6):470-7
pubmed: 26517324
Subst Abuse Rehabil. 2019 Nov 29;10:69-78
pubmed: 31819701
Ann Emerg Med. 2021 Dec;78(6):759-772
pubmed: 34353655
JAMA Health Forum. 2022 Jun 24;3(6):e221757
pubmed: 35977240
J Subst Abuse Treat. 2015 May;52:48-57
pubmed: 25601365
JAMA Netw Open. 2023 May 1;6(5):e2312030
pubmed: 37145594
Psychiatr Serv. 2019 Jul 1;70(7):617-620
pubmed: 31035894
Drug Alcohol Depend. 2023 Jul 1;248:109933
pubmed: 37267746
Health Aff (Millwood). 2020 Jun;39(6):984-992
pubmed: 32479224
J Subst Abuse Treat. 2018 Dec;95:9-17
pubmed: 30352671