OBJECTIVES Buprenorphine/naloxone (BUP/NAL) combination is a well known treatment for opioid dependence. As a chronic relapsing disorder, some patients alternate between periods of on treatment and off treatment.  The aim of this study was to compare health care resource utilization and costs between these patients and patients treated continuously. METHODS Statistical analyses were conducted on a Medicaid insurance claims database (TruvenHealth MarketScan® Medicaid) from January 2007 to June 2012. Patients with at least two treatment episodes in the first year after the initial filled prescription were identified.  The end of a treatment episode was defined as a period of 60 days with no filled BUP/NAL prescriptions following the theoretical end of the last filled prescription. An ordered logistic regression model was used to analyze the impact of initial treatment episode duration on the number of new episodes in the year following the end of the first episode. Healthcare resource utilization and related costs during the first year after initiation were compared between the two groups. RESULTS