Reduced mortality on Suboxone

Items of interest from my practice and academia, and political or regulatory information about buprenorphine and addiction. If you have something that you would like me to address, send me an e-mail.
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Reduced mortality on Suboxone

Post by suboxdoc »

Very strange.... but a very large study in almost a million people found that maintenance treatment with buprenorphine resulted in significantly reduced all-cause mortality. We're not just talking reduced deaths from overdose, which was expected and clearly occurred... it also showed reduced death rates from all other causes, including cancer. ... ct/2780655

I haven't drilled down into the data yet, but this isn't a case report -- this is an analysis of a very large population. It clearly shows that the people who say 'Suboxone is slowly killing you' are simply wrong....

There was a similar study of benzos a few years ago from the NHS in Great Britain that showed HIGHER all-cause mortality in people who took benzos. The increased deaths were from a wide range of diseases.

Why does maintenance on buprenorphine reduce cancer death rates? Who knows. If anyone reads the article and has some thoughts, let's hear your ideas!
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Re: Reduced mortality on Suboxone

Post by Cytokrom C »

I have not scrutinized these results myself, but cohort studies are generally not useful to determine causation. The problem is that you cannot separate between whether the effect (reduced mortality) is caused by the intervention (buprenorphine) or if both the effect and the intervention correlate with some other parameter (or indeed even if the intervention is caused by the effect...).

And there are often loads of other plausible explanations for an association than a causative relationship. A few examples from the study abstract:
  • People that have the internal drive to engage in treatment are less likely to be severely depressed and to commit suicide (=> depression is the common parameter determining both suicide and likelihood of treatment engagement)
  • An overall healthier lifestyle may correlate with both engagement in treatment and lower cardiovascular mortality
  • Terminally ill cancer patients may more often have to quit buprenorphine treatment in order to treat cancer-related pain with full mu agonists.
Etc... (I am sure you could easily come up with a dozen more non-causative associations...)

So you need to be very careful in concluding that associations signify causality from these types of studies. (That is why randomized controlled studies is the current scientific standard for assessing efficacy...)
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Re: Reduced mortality on Suboxone

Post by Crazy_Cat_Lady »

I am interested in this topic. I worry constantly about how much damage Sub is doing to my body.
Thanks for posting.
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