From the FDA Drug Label
2 DOSAGE AND ADMINISTRATION
- 1 Important Dosage and Administration Instructions Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals [see Warnings and Precautions (5)] Initiate the dosing regimen for each patient individually, taking into account the patient's severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse [see Warnings and Precautions (5. 1)] .
The FDA drug label does not answer the question.
From the Research
Kadian (morphine sulfate extended-release) is not FDA-approved or recommended for the treatment of opioid use disorder. The standard medications approved for opioid use disorder are methadone, buprenorphine (Suboxone, Subutex), and naltrexone (Vivitrol) 1. Kadian is a long-acting opioid analgesic used for pain management in opioid-tolerant patients requiring around-the-clock pain control, not for addiction treatment. Using Kadian for opioid use disorder would be inappropriate and potentially dangerous as it lacks the pharmacological properties needed for addiction treatment.
Methadone (typically 80-120 mg daily) and buprenorphine (typically 16-24 mg daily) are the primary medication options for opioid use disorder as they help reduce withdrawal symptoms, decrease cravings, and block the euphoric effects of other opioids while having lower abuse potential or better safety profiles than full agonists like morphine 2, 1. These medications should only be prescribed within appropriate treatment programs with proper monitoring and counseling support.
Some studies have explored the use of contingency management and behavioral therapies in conjunction with medication-assisted treatment for opioid use disorder, highlighting the importance of a comprehensive approach to treatment 3, 4. However, the primary focus should remain on the use of FDA-approved medications like methadone, buprenorphine, and naltrexone, as they have the strongest evidence base for effectiveness in treating opioid use disorder.
In clinical practice, the choice of medication should be individualized based on patient needs and circumstances, with careful consideration of factors such as medical history, potential for drug interactions, and the presence of co-occurring psychiatric or medical conditions 1. Ultimately, the goal of treatment should be to improve patient outcomes in terms of morbidity, mortality, and quality of life, and to support long-term recovery from opioid use disorder.