Tapering

Discontinuing Buprenorphine:

The discontinuation phase of buprenorphine treatment involves a gradual reduction or tapering from the patient's maintenance dose.

1. Discontinuing buprenorphine is not required. Patients can continue buprenorphine therapy indefinitely (SAMHSA, 2004):

Related Resources: 
Description: 
Discusses protocols for office-based buprenorphine treatment, including the administering of the drug itself, devising a treatment plan, and choosing an appropriate frequency for visits.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Physician stage in practice: 

Day 1

Description: 
Dosing Flowchart of Buprenorphine Induction for Patients Dependent on Long-Acting Opioids

This dosing flow chart depicts clinical dosing guidelines for patients physically dependent on long-acting opioids such as methadone. Guidelines are provided for what to do if the patient's withdrawal symptoms continue or return, and establishing the daily dose if the symptoms are relieved.

© 2012, Clinical Tools, Inc.

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Resource Type: 
Physician stage in practice: 
Description: 
This journal article compares the effectiveness of detoxification vs. continuing buprenorphine-naloxone therapy for treating opioid-addicted adolescents. The study followed 152 patients between the ages of 15 and 21 who were randomly selected to receive either a 12-week buprenorphone-naloxone program, or a 14-day taper.
Source: 
The Journal of the American Medical Association (JAMA)
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Physician stage in practice: 
Resource Type: 

After stabilizing on buprenorphine, patients may request to be tapered off of buprenorphine. Discontinuing buprenorphine in stable patients should be discussed thoroughly with the patients and their significant others. Unfortunately, relapse rates are high and patients should be encouraged to return for maintenance treatment if cravings develop after withdrawal.

Related Resources: 
Description: 
Discusses protocols for office-based buprenorphine treatment, including the administering of the drug itself, devising a treatment plan, and choosing an appropriate frequency for visits.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
field_vote: 
Physician stage in practice: 
Description: 
Information on the dose-reduction phase, or taper from buprenorphine. Discusses long, moderate, and short-period reductions, and the potential benefits and downfalls of each.
Source: 
suboxoneassistedtreatment.org
field_vote: 
Physician stage in practice: 
Description: 
Discusses protocols for office-based buprenorphine treatment, including the administering of the drug itself, devising a treatment plan, and choosing an appropriate frequency for visits.
Source: 
Substance Abuse and Mental Health Services Administration (SAMHSA)
field_vote: 
Physician stage in practice: 
Description: 
This continuing education course instructs physicians, physician assistants, and nurse practitioners who prescribe narcotics on some the requirements and subtleties of buprenorphine treatment that can lead to effective and relatively safe treatment of opioid use disorder.
Source: 
Clinical Tools, Inc.
field_vote: 
Description: 
This flow chart for buprenorphine treatment displays the steps to patient recovery, from initial patient contact or referral, through intake process, induction, day #2, stabilization, maintenance, and tapering.
Source: 
Colleen LaBelle, RN/Boston Medical Center
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Physician stage in practice: 
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