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Member Research & Reports

Member Research & Reports

BU: Instead of Opioid Detox ‘Revolving Door,’ a ‘Bridge’ to Long-Term Treatment

Three out of four people who complete an inpatient opioid withdrawal management program — commonly known as “detox” — relapse within a month, leading to what some opioid use disorder researchers describe as a “revolving door.” Few successfully transition to long-term treatment with proven medications such as buprenorphine, methadone, or naltrexone to prevent overdose.

Starting patients on long-term, primary care-based buprenorphine treatment while in detox would be more effective than simply offering a referral for such treatment as they leave detox, according to a new study led by a Boston University School of Public Health (BUSPH) researcher.

Published in the journal Addiction, this is the first randomized trial comparing the two strategies. Patients who started buprenorphine treatment at the detox program were less likely to use opioids illicitly over the following six months, and more likely to keep up treatment.

“The idea of detox — getting inpatient treatment for a few days and expecting to quit opioids — has always been magical thinking,” says study lead author Dr. Michael Stein professor and chair of health law, policy & management at BUSPH. “We’ve quantified here for the first time how successful we can be if we use short-term inpatient programs as starting grounds for long-term treatment.”

Buprenorphine, itself a lower-risk opioid, has been shown to significantly reduce the odds of overdose among people with opioid use disorder.

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