Rapid induction to extended-release buprenorphine 300-mg injection feasible and well tolerated for those using fentanyl
By Elana Gotkine HealthDay Reporter
WEDNESDAY, Nov. 8, 2023 (HealthDay News) — For individuals with opioid use disorder (OUD) using fentanyl, a one-day induction of extended-release buprenorphine is a feasible treatment approach, according to a study published online Nov. 8 in the American Journal on Addiction.
John J. Mariani, M.D., from the New York State Psychiatric Institute in New York City, and colleagues conducted a secondary analysis of results grouped by fentanyl use status for an open-label study with rapid induction of extended-release buprenorphine in the inpatient research unit. A single 4-mg dose of transmucosal buprenorphine (BUP-TM) was administered to eligible participants, followed by an extended-release buprenorphine 300-mg injection (BUP-XR) after approximately one hour. Follow-up was continued to six months in an extension study (six monthly injections).
All 19 participants with fentanyl-positive urine samples (FEN+) received BUP-TM, 17 received BUP-XR, 13 chose to receive a second BUP-XR, and 10 received all six scheduled injections. All seven participants with fentanyl-negative urine samples (FEN−) received BUP-TM and BUP-XR, four elected to receive a second injection, and two received all six injections. The FEN+ and FEN− groups had similar induction-day clinical opioid withdrawal scale (COWS) scores. Within 24 hours of BUP-XR injection, mean COWS scores fell to below 5 in the FEN+ group.
“Fentanyl and other synthetic opioids are the leading cause of overdose deaths in the United States and rapid induction to BUP-XR injection may be an important potential treatment option for this at-risk population,” the authors write.
Several authors disclosed ties to Indivior, which funded the study.
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