This summarythat recent buprenorphine study suggests that the muddy waters are settling [emphasis mine]:
This study shows, yet again, that buprenorphine / naloxone is an effective treatment for opioid dependence as long as it is maintained, and that a tapering detoxification strategy, regardless of duration, fails the majority of patients.
The summary then goes on to argue for a medicalized treatment approach that puts pharmacology front and center:
As with the treatment of hypertension or diabetes, as long as the patient takes the medication, it works; when the medication is stopped, the disorder returns. The chronic nature of opioid dependence is worth reiterating in light of recovery-oriented orthodoxy and insurance requirements that mandate time limits on opioid agonist treatment. This study also found intensive counseling added nothing to SSM. Perhaps the time is coming when appropriate treatment will be called “counseling-assisted pharmacotherapy” rather than “medication-assisted treatment,” an acknowledgment that medication, not detoxification with counseling, should be the first-line treatment for opioid dependence.
I couldn’t disagree more with the conclusions the reviewer reaches, but I appreciate the clarity.
The next big question will be what kind of recovery this approach produces. Do these patients enjoy full recovery or some more limited version? (Brings me back to the question of whether mutual aid recovery is to addiction what exercise is to cardiac treatment. This would make buprenorphine like a stent.)