ReviewDrug and alcohol dependence2014
Buprenorphine maintenance and mu-opioid receptor availability in the treatment of opioid use disorder: implications for clinical use and policy.
Review in Drug and alcohol dependence, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
84 citing papers in PubMed, 4 syntheses or guidelines pooled it, 167 citations in OpenAlex.
- Consensus Statement on Pain Management for Pregnant Patients with Opioid-Use Disorder from the Society for Obstetric Anesthesia and Perinatology, Society for Maternal-Fetal Medicine, and American Society of Regional Anesthesia and Pain Medicine.Anesthesia and analgesia · 2025Guideline
- Opioid-induced analgesia among persons with opioid use disorder receiving methadone or buprenorphine: A systematic review of experimental pain studies.Drug and alcohol dependence · 2021Pooled it
- Buprenorphine for Chronic Pain: a Systemic Review.Current pain and headache reports · 2018Pooled it
- A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature.Journal of addictions nursingPooled it
- Extended-Release vs Sublingual Buprenorphine in Pregnancy Through 12 Months Post Partum: A Randomized Clinical Trial.JAMA internal medicine · 2026Trial
- Comparison of Extended-Release Buprenorphine Doses for Treating High-Risk Opioid Use: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Rapid vs Standard Induction to Injectable Extended-Release Buprenorphine: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Relationship between opioid cross-tolerance during buprenorphine stabilization and return to opioid use during buprenorphine dose tapering.Psychopharmacology · 2024Trial
- Examining the benefit of a higher maintenance dose of extended-release buprenorphine in opioid-injecting participants treated for opioid use disorder.Harm reduction journal · 2023Trial
- Association between dynamic dose increases of buprenorphine for treatment of opioid use disorder and risk of relapse.Addiction (Abingdon, England) · 2022Trial
- Population Pharmacokinetics of a Monthly Buprenorphine Depot Injection for the Treatment of Opioid Use Disorder: A Combined Analysis of Phase II and Phase III Trials.Clinical pharmacokinetics · 2021Trial
- MySafeRx: a mobile technology platform integrating motivational coaching, adherence monitoring, and electronic pill dispensing for enhancing buprenorphine/naloxone adherence during opioid use disorder treatment: a pilot study.Addiction science & clinical practice · 2018Trial
- Effect of Buprenorphine Weekly Depot (CAM2038) and Hydromorphone Blockade in Individuals With Opioid Use Disorder: A Randomized Clinical Trial.JAMA psychiatry · 2017Trial
- Predictors of buprenorphine initial outpatient maintenance and dose taper response among non-treatment-seeking heroin dependent volunteers.Drug and alcohol dependence · 2015Trial
- Discontinuing extended-release buprenorphine: Participant experiences from a mixed-methods observational study.Drug and alcohol dependence reports · 2026Article
- Review
- Reframing Buprenorphine as a Pharmacologic Modifier of Opioid-Induced Respiratory Depression in the Fentanyl Era.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Perioperative Management of Patients on Buprenorphine.Current pain and headache reports · 2026Review
- Reduced need for inpatient care following introduction of long-acting injectable buprenorphine.BMC health services research · 2025Article
- Medicaid managed care restrictions on medications for the treatment of opioid use disorder.Health services research · 2025Article
24 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSublingual formulations of buprenorphine (BUP) and BUP/naloxone have well-established pharmacokinetic and pharmacodynamic profiles, and are safe and effective for treating opioid use disorder. Since approvals of these formulations, their clinical use has increased. Yet, questions have arisen as to how BUP binding to mu-opioid receptors (μORs), the neurobiological target for this medication, relate to its clinical application. BUP produces dose- and time-related alterations of μOR availability but some clinicians express concern about whether doses higher than those needed to prevent opioid withdrawal symptoms are warranted, and policymakers consider limiting reimbursement for certain BUP dosing regimens.
methodsWe review scientific data concerning BUP-induced changes in μOR availability and their relationship to clinical efficacy.
resultsWithdrawal suppression appears to require ≤50% μOR availability, associated with BUP trough plasma concentrations ≥1 ng/mL; for most patients, this may require single daily BUP doses of 4 mg to defend against trough levels, or lower divided doses. Blockade of the reinforcing and subjective effects of typical doses of abused opioids require <20% μOR availability, associated with BUP trough plasma concentrations ≥3 ng/mL; for most individuals, this may require single daily BUP doses >16 mg, or lower divided doses. For individuals attempting to surmount this blockade with higher-than-usual doses of abused opioids, even larger BUP doses and <10% μOR availability would be required.
conclusionFor these reasons, and given the complexities of studies on this issue and comorbid problems, we conclude that fixed, arbitrary limits on BUP doses in clinical care or limits on reimbursement for this care are unwarranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.