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Emerging Drug of Abuse: OXI

Long-term buprenorphine-naloxone treatment reduces opioid use by those dependent on prescription painkillers, according to the first randomized, controlled trial using a medication for the treatment of prescription opioid dependence. Nearly one-half (49%) of those receiving 12 weeks of treatment with the opioid buprenorphine-naloxone reduced their use of other opioids.* However, eight weeks after the buprenorphine-naloxone treatment was tapered off and discontinued in accordance with the study protocol, only 9% had reduced their opioid use. Thus 91% of the study participants were not opioid-free at follow-up. According to the authors, ÒThe high rate of unsuccessful outcomes after buprenorphine-naloxone taper is notable in light of the good prognostic characteristics of the population (i.e., largely employed, well educated, relatively brief opioid use histories, and little other current substance abuse) and previous research suggesting that patients dependent on prescription opioids might have better outcomes than those dependent


on heroinÓ. The authors suggest that future research look at Òwhat length of buprenorphine-naloxone treatment, if any, would lead to substantially better outcomes after a taperÓ