Phases of Buprenorphine Treatment

Buprenorphine maintenance can be divided into three phrases: induction, stabilization, and maintenance.


The goal of the induction is to find the patient's ideal daily dose of buprenorphine. The ideal daily dose minimizes both side effects and drug craving. For most opioid-dependent patients, the daily dose is 12 to 16 mg/day of the buprenorphine+ naloxone combination film or tablet. Induction usually takes 2 to 4 days to complete.


Stabilization occurs in the 6 to 8 weeks following induction. This period begins when the patient is no longer experiencing withdrawal symptoms or intense cravings.The main goal of stabilization is to eliminate opioid use, as noted by patient reports and confirmed by urine drug testing.


The maintenance phase lasts indefinitely (SAMHSA 2004). Long-term maintenance is recommended due to high relapse rates. For example, in one study of 255 individuals, approximately 87% relapsed at 3 months (Ling 2009). During this phase, the patient is maintained at a comfortable dose and reports minimal craving or side effects.