How Effective is Suboxone?

By Victoria Kim 02/28/17

A new study examined the efficacy of medication-assisted treatment on new buprenorphine users. 

Doctor holding medication

Amid rising opioid addiction and overdose in the United States, medication-assisted treatment (MAT) got the stamp of approval from medical and behavioral health professionals, and even the U.S. government.

Last year, the Obama administration expanded access to buprenorphine—the semi-synthetic opioid medication that’s used to treat opioid addiction—by raising the number of patients that certain doctors can treat with the drug (branded as Suboxone or Subutex) from 100 to 275.

But just how effective is MAT? A new study published last Thursday (Feb. 23) in the Addiction journal sought to find out, and discovered that the treatment works better on paper than in practice. 

The study looked at pharmacy data of 38,000 new buprenorphine users from 11 states, and found several factors that undermine the success of MAT. 

First, the researchers, led by Dr. Caleb Alexander of the Johns Hopkins Bloomberg School of Public Health, found that roughly half of patients undergoing MAT filled an opioid prescription during or after treatment. “Approximately 43% of buprenorphine recipients filled an opioid prescription during the treatment episode and 67% filled an opioid prescription following treatment,” according to the study.

Dr. Alexander says this suggests a disconnect between patients and doctors who may be unaware that patients are receiving opioid medication from other prescribers. It’s also indicative that not many prescribers are using prescription drug monitoring databases to track patients’ past scripts.

The researchers also found that many MAT patients did not continue the treatment for a sufficient amount of time. The minimum time a person should remain on buprenorphine, in conjunction with behavioral therapy, is six months. But the average treatment among those observed in the study lasted 55 days—or less than two months.

The idea behind MAT is a dual approach—the patient uses buprenorphine while engaging in a non-drug intervention like behavioral therapy. But another undermining factor is that MAT patients are not required to seek counseling.  

Adam Brooks, who studies addiction therapies at the Treatment Research Institute in Philadelphia, told that it’s not realistic for doctors—who receive training to be able to prescribe buprenorphine—to provide the intensive support, structured therapy, and regular testing that is necessary for success. 

The study’s findings highlight the obstacles that patients with opioid use disorder face. “We know from other settings that medication-assisted treatment works,” said Dr. Alexander. “However, it is a big difference between showing that effect in a clinical trial and showing that effect in the real world.”

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Victoria is interested in anything that has to do with how mind-altering substances impact society. Find Victoria on LinkedIn or Tumblr