Buprenorphine Maintenance Therapy Versus Detoxification for Opioid Use Disorder: A Clinical Review

Authors

• Sarah A. Marsh, University of LynchburgFollow

Specialty

DMSc

Advisor

Dr. Victoria Beloy

Abstract

Background: Opioid use disorder (OUD) is a major driver of preventable death and disease burden in the United States. While detoxification remains an approach to managing opioid addiction, research increasingly shows that it is associated with poor outcomes, namely relapse and overdose; medication for opioid use disorder, particularly buprenorphine therapy, has become standard treatment for patients with OUD on a long-term basis.

Methods: Research completed a clinical review of seven level 1 sources, including PubMed-searchable randomized controlled trials, systematic reviews and meta-analyses, and high-quality observational cohort studies, to assess current evidence comparing clinical outcomes in patients who receive detoxification or buprenorphine maintenance therapy for OUD, as well as current literature detailing evolving practices for initiation and delivery of buprenorphine therapy for OUD.

Results: Randomized controlled trials, observational cohort studies, and reviews showed consistently improved treatment retention, lower relapse rates, and decreased risk of overdose and mortality among patients who received buprenorphine maintenance therapy compared to those who underwent detoxification alone.

Conclusions: OUD is a relapsing condition that is not effectively or safely managed with detoxification alone. Buprenorphine maintenance should be used as first-line treatment for patients with OUD; additional strategies to improve induction rates and new long-acting injectable formulations are promising solutions to reduce barriers and improve continuity of care.

Recommended Citation

Marsh SA. Buprenorphine Maintenance Therapy Versus Detoxification for Opioid Use Disorder: A Clinical Review. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).