People with opioid use disorder who are prescribed a lower dose of buprenorphine are 20% more likely to discontinue treatment than those who are on a higher dose, a new study concludes.

The study, supported by the National Institute on Drug Abuse (NIDA), suggests the need to re-evaluate opioid addiction treatment recommendations in the era of fentanyl, the researchers said.

They studied patients prescribed buprenorphine in Rhode Island from 2016 to 2020, as fentanyl became more widely available. They compared those who were prescribed 16 milligrams daily (the current recommended dose) to those prescribed 24 milligrams. They found patients prescribed the recommended dose were significantly more likely to discontinue treatment over 180 days compared to those prescribed the higher dose.

“Effective treatment can save lives, but our proven treatments for opioid use disorders must evolve to match the challenges posed by the fentanyl crisis,” said NIDA Director Nora Volkow, M.D., in a news release. “If science continues to demonstrate that a higher dosage of buprenorphine increases treatment retention, we must reevaluate clinical guidelines to optimize treatment and help people achieve recovery.”