We believe that this systematic review adds to the growing body of literature that suggests that buprenorphine is safe to use in multiple populations, including those with opioid dependence and chronic pain.16,59,60 In contrast, long-term full MOR agonists present significant risks for harmful or fatal overdose, all-cause mortality, and morbidity.1,2,6 Thus, this synthesis supports the hypothesis that rotation from full MOR agonists to buprenorphine would reduce harm, although more research is needed into the best way to complete such rotation. This evidence concerns the gene OPRM1 and opiate dependence.