Original Research J Clin Psychiatry January 2026

Identifying Optimal Thresholds for Early Opioid Use Frequency in Predicting Buprenorphine Outcomes

Full Article Read the complete peer-reviewed article in J Clin Psychiatry. Clinical Summary Many patients starting buprenorphine continue using opioids in the first few weeks, but clinicians have had little guidance on how much early use should trigger concern. This study identifies practical early-use thresholds that help flag patients at higher risk for sustained opioid use, fewer opioid-free weeks, and earlier dropout from treatment. FAQ How much opioid use in the first 2 weeks of buprenorphine treatment should raise concern? 11 questions
Key Takeaways The 2 candidate thresholds serve different clinical purposes: the weeks 1–2 cutoff showed higher sensitivity than specificity (0.747 vs 0.688), whereas the weeks 1–3 cutoff showed higher specificity than sensitivity (0.810 vs 0.649), which may help clinicians match lower-intensity versus more resource-intensive responses to risk. 6 takeaways Clinical Guide How should clinicians use opioid use reported in the first 2 weeks of buprenorphine treatment to identify patients at risk for poor short-term outcomes? 5 steps Clinical Guide How can clinicians use opioid use during the first 3 weeks of buprenorphine treatment to more specifically identify patients at higher risk for sustained opioid use? 6 steps
Physicians Postgraduate Press, Inc. (PPP) makes no warranties about the accuracy or completeness of any information published in The Journal of Clinical Psychiatry or other PPP materials, and disclaims liability for any use or non-use of that information. Clinicians should not rely solely on these materials and should exercise their own professional judgment when making patient care decisions on an individualized basis.

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