• Michael D Stein, Micah T Conti, Debra S Herman, Bradley J Anderson, Genie L Bailey, Donnell Van Noppen, and Ana M Abrantes.
• Department of Behavioral Medicine and Addictions Resaerch, Butler Hospital, Providence, Rhode Island.
• Am J Addict. 2019 Jul 1; 28 (4): 270-276.

Background And ObjectivesDespite the benefits of maintenance buprenorphine treatment for opioid use disorder (OUD), many individuals report an interest in discontinuing the medication, while also expressing worries about tapering. The purpose of this study was to develop a measure of worries about buprenorphine discontinuation ("Off Bupe") and determine the demographic and clinical characteristics associated with these worries.MethodsBetween May 2017 and May 2018, we surveyed adults in an outpatient primary care buprenorphine program (n = 138). Reliability and validity of the Off Bupe measure were examined.ResultsParticipants averaged 39 years of age, 54% were male, average duration of buprenorphine was 189 weeks and 85.5% reported eventually wanting to discontinue buprenorphine, although fewer than 10% were actively tapering. We derived two scales, withdrawal symptom worry (10 items, ɑ = 0.94) and relapse worry (7 items, ɑ = 0.88). Worry about symptoms was positively associated with current buprenorphine dose (P = 0.016), physical discomfort avoidance (P < 0.001), and inversely associated with self-efficacy to quit buprenorphine (P < 0.001) and distress tolerance (P < 0.001). Worry about opioid relapse was associated positively with age (P = 0.019), current buprenorphine dose (P = 0.004), physical discomfort avoidance (P < 0.001), and impulsivity (P = 0.002), and inversely associated with self-efficacy to quit buprenorphine (P < 0.001).Discussion And ConclusionsPsychometric evaluation of the "Off Bupe" scale demonstrated its content and construct validity and internal reliability.Scientific SignificanceThe scale might help individuals with OUD and their providers identify concerns about discontinuing buprenorphine. (Am J Addict 2019;28:270-276).© 2019 American Academy of Addiction Psychiatry.

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