Key Points Question Among people receiving buprenorphine maintenance therapy and undergoing a taper, what prescribing characteristics are associated with opioid overdose? Findings In this cohort study of 5774 individuals undergoing… Click to show full abstract
Key Points Question Among people receiving buprenorphine maintenance therapy and undergoing a taper, what prescribing characteristics are associated with opioid overdose? Findings In this cohort study of 5774 individuals undergoing a buprenorphine taper, a longer time to taper initiation (≥1 year vs <1 year), a lower mean rate of taper (≤2 mg per month and >2 to ≤4 mg per month vs >4 mg per month), and a lower percentage of days during which the dose was decreasing (≤1.75% vs >3.50% of taper days) were significantly associated with a reduced risk of opioid overdose. Taper duration was not significantly associated with overdose. Meaning Buprenorphine tapers undertaken after at least 1 year of therapy, those with a slower rate of taper, and a lower percentage of days during which the dose was decreasing were associated with a significantly lower risk of opioid overdose, regardless of taper duration.
               
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