A new study finds that buprenorphine, a medication used to treat opioid addiction, greatly lowers the risk of overdose among teens and young adults—but only when taken as prescribed for a long time.
Researchers tracked nearly 12,000 young people aged 13 to 26 in Massachusetts who started buprenorphine treatment between 2014 and 2020. Those who stayed on the medication for at least one year were much less likely to overdose or be hospitalized due to opioid use.
However, patients who stopped buprenorphine within nine months faced a higher risk of overdose. Those quitting within 3 to 9 months had an 82% greater overdose risk, while stopping before 3 months raised the risk by 76%.
Taking buprenorphine exactly as prescribed also matters. Even with one year of treatment, irregular use raised overdose risk by 46% compared to consistent use.
Dr. Scott Hadland, lead author and chief of adolescent medicine at Mass General Brigham, said this study answers a common question about how long young people should stay on this medication. “Our findings show that staying on buprenorphine for at least a year and taking it regularly saves lives,” he said.
Buprenorphine works by activating the same brain receptors as opioids, reducing cravings and lowering overdose risk. Many patients stop treatment early when they start feeling better, but this research suggests long-term use is crucial to prevent relapse.
Dr. Hadland emphasized that opioid addiction can fluctuate over several years. “Even when things seem better, continuing treatment helps avoid relapse and overdose,” he explained.
To support young people, healthcare providers should offer long-acting injectable buprenorphine and help address mental health or housing problems that often accompany opioid use disorder.
“Especially in today’s fentanyl crisis, short-term treatment is not enough,” Hadland said. “Doctors, insurers, and health systems must do more to ensure youth stay on medication for at least a year or longer to lower overdose deaths.”
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