biostudies-literatureBecker WCNCIPC CDC HHSNCATS NIH HHSNIDA NIH HHSHSRD VA372-381https://www.ebi.ac.uk/biostudies/studies/S-EPMC11833656biostudies-literatureUnknown185(4)<h4>Importance</h4>Guidelines recommend dose reduction or discontinuation of long-term opioid therapy when harm outweighs benefit, but strategies to help patients do so are limited.<h4>Objective</h4>To test optionally switching to buprenorphine as a strategy for improving pain and reducing opioids among patients prescribed high-dose, full agonist long-term opioid therapy.<h4>Design, setting, and participants</h4>In this pragmatic, multisite, 12-month randomized clinical trial with masked outcome assessment, patients treated at Veterans Affairs primary care clinics were recruited from October 2017 to March 2021, with follow-up completed June 2022. Eligible patients had moderate to severe chronic pain despite high-dose opioid therapy (≥70 mg/d for at least 3 months). Patients were randomizedJAMA internal medicineBuprenorphine, Pain, and Opioid Use in Patients Taking High-Dose Long-Term Opioids: A Randomized Clinical Trial.PMC11833656R01 CE003668I01 HX003411K23 DA047475UL1 TR001863Aryal APatel AUgbo ECarr MAtkins DNaylor JSvabek KWilliams BTappainer CKross TCarr TAllen KDSloan JBaskin JClay MGlenn RSacra EAnicich AWalker JCutting AHawkins JHuffman KFMcKissack MKats AMStoll SNjau EThomas GRFeuchs ASabet RFLorenzo JSalameh HBohnert ASellinger JStoner TMaloy PManuel JSurginer BMundt JJones EBartlett SSculley MUdouj RBuonora MNichols AByerly STheis AGivens CVarughese SRMiller EStoll JSumner JAOkere JBorowa DMapara PAnkawi BHepton SCraine MMarcy BBacke KReed JVOICE Study GroupBarbosa MGarvey CRouse RRutks IGodwin KGalvan RGosselin KGrimm KFPackard-Milam MWolfman AButler CAShah Barman MGoldstein MBonchak JHyde SSides TWiener CHGayle SEichelsdoerfer ENelson ADePesa NKrebs EEPinsonnault JBroderick DLewis MKerns RRomano EMarek LOlney RLDadabayev AReddy SWilbur EStrand MAmundson EAtkinson TPurcell NThomas LCMoon JOlson JSadowski NSharpe PHall LMLibrodo SSeal KHStevens SArnold SJensen ABlehm RHarden JLaHaie EHidalgo NBuesgens CMorris HSiver MFeighner LRoca HHorowitz DJohnson ELindsay DReznik TEHammett PSandbrink FBrudvik ESilver KETiene KBartnik MKDrexler KRoberti ARozzero PCoy WBBhushan SOakley JWPainter JTBordanea MJacobson KTaylor BCCulver DErwin KFrontera RACariveau DEdmond SNBoesch NBrown CBOsler BDaly DVenkatraman SChandler MDike DHeuermann BMcCamish NOfstad HTat CRezaei DBecker WCWestmoreland WCBowden MFike AGumidyala AHoffmann JHolland-Deguire CLagisetty PDuvall TRettmann NLively-Brindley LBurch RBajpai SBolander SRosema TDesmet PBuchanan KKaiser BPhilippe MHerynk AMason BSeys RDiokpa CBooth KBorsari BAbelleira ASchroeder AMarcolivio KLuciani LFrank JWPalyo SMixon ASBarnett SNoh MClarke KAdams MHagedorn HJDrum-Oden ACervone DHudson TSwanson GEllison JBaller KEscobedo CDeRonne BMLelovic MWoloszyn MMahal-Lichty JLahidji SSauve CWang GLinden EWatson KWatson EDenietolis ALSchopmeyer KANolan CHale AFreeman JTHuang AHerbst EKnutson RLe GNugent SBangerter AKavathekar ROsborne JHope KNazario MMakris UEByrd GBrooks KMorasco BJByrd CFinetti TBoening NGraham SDevlin AZanga JSewell KViera KBritnell SDogra MKauzlarich KPeter DOrtolan VBurton CSon ECarmody SDegerstrom RBaxley CNelson DBBair MEllifritz CFranchina LMarraffa RSmith CNolan PBronars CZuniga SHunt NERobinson VEads FKLusk CCampbell EHagerman CBloechl PPBolf MfalseBuprenorphine, Pain, and Opioid Use in Patients Taking High-Dose Long-Term Opioids: A Randomized Clinical Trial.<h4>Importance</h4>Guidelines recommend dose reduction or discontinuation of long-term opioid therapy when harm outweighs benefit, but strategies to help patients do so are limited.<h4>Objective</h4>To test optionally switching to buprenorphine as a strategy for improving pain and reducing opioids among patients prescribed high-dose, full agonist long-term opioid therapy.<h4>Design, setting, and participants</h4>In this pragmatic, multisite, 12-month randomized clinical trial with masked outcome assessment, patients treated at Veterans Affairs primary care clinics were recruited from October 2017 to March 2021, with follow-up completed June 2022. Eligible patients had moderate to severe chronic pain despite high-dose opioid therapy (≥70 mg/d for at least 3 months). Patients were randomized2025-01-01T00:00:00Z2025 Apr2026-07-15T22:11:57.235Z2026-07-09T10:20:47.641ZS-EPMC118336563996073010.1001/jamainternmed.2024.8361