Injectable-Only Overlapping Buprenorphine Starting Protocol in a Low-Threshold Setting

What outcomes are associated with an injectable-only buprenorphine starting protocol in a low-threshold outpatient setting among individuals with opioid use disorder using fentanyl?In this cohort study of 95 patients with moderate to severe opioid use disorder using unregulated fentanyl, these patients chose a protocol that involved 3 escalating long-acting injectable buprenorphine doses over 3 days without requiring cessation of fentanyl and without sublingual buprenorphine. Most of these individuals (75%) completed the protocol and 64% received a second monthly long-acting injectable buprenorphine dose.The findings suggest that an injectable-only buprenorphine starting protocol is a promising potential pathway for patients to start this lifesaving medication in the outpatient setting.

Corresponding Author: Richard C. Waters, MD, MSc, Downtown Emergency Service Center, 515 Third Ave, Seattle, WA 98104 (watersr@uw.edu).

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