Taper Duration in Primary PrescriptionOpioid Abusers

With the continued increase of opioid analgesic use in the United States,1 there is a parallel increase in opioid use disorder specifically involvingprescription opioids (POs).2 Thepercentageof admissions into substance abuse treatment facilities for pharmaceutical opioid dependencetreatmenthas increasedfromless than1.0%duringand before1997to9.8%in2011.3Bycontrast,admissions forherointreat-ment have fluctuated between 14 % and 15.5 % for the past 15 years. Increases in drug-related crime and spread of infectious disease are 2 societal consequences of increased opioid use disorder. Treatment usually begins by reducing or eliminating uncon-trolled use of the abused opioid agonists. Widespreadmethadone maintenance treatment availabilityprovides analternative toacute withdrawal followed by self-monitored abstinence facilitating re-duced relapse to the abused opioid. Strengths and weaknesses of methadone maintenance have been studied and well docu-mented. More recently, buprenorphine replacement therapy has capitalizedonmanyof the strengthsof themethadonemodelwhile reducing barriers to treatment with its availability in mainstream medical care settings.Withbothmethadoneandbuprenorphine as tools, agonistmaintenance therapy reduces opioid use in patients. However, significant barriers to accessing agonist maintenance therapy remain.4 The study by Sigmon et al5 published in JAMA Psychiatry high-lights a different treatment model in the general class of treat-ments known as buprenorphine medication-assisted treatment (BMAT). Althoughmost patientswith opioid usedisorder receiving agonist therapy continue to receive maintenance therapy for 6 months ormore, Sigmon et al demonstrated short-term treatmen