Prolonged-Release Buprenorphine Therapy in Opioid Use Disorder Can Address Stigma and Improve Patient Quality of Life

Abstract

Treatment for opioid use disorder (OUD) including opioid agonist therapy (OAT) is effective. Medication with the oral administration of methadone and buprenorphine has well-known limitations (establishing consistent optimal dosing levels, misuse, diversion, and accidental exposure). Treatment may require attendance at treatment services for collection and consumption of medication; this is associated with stigma and discrimination. Novel therapeutic options include approved, injectable, prolonged-release buprenorphine (PRB) products providing consistently optimal drug levels and less frequent dosing. This work assesses the lived experience of persons currently engaged in OUD therapy to define the potential value of novel therapeutic options in order to inform treatment decisions.One hundred and twenty-two people engaged with treatment services participated in this assessment. Seventy-two percent of participants believed that novel therapeutic options would improve quality of life and 67% stated it would reduce stigma and discrimination. Participants were neither concerned about the efficacy of (net score negative 30%), or lack of control over (net score negative 36%) treatment, nor about reduced contact with treatment services (net score negative 11%). Results from this assessment indicate that the provision of choice including novel therapeutic options is likely to improve quality of life and reduce the stigma of persons with OUD.

Effectiveness and Public Health Impact of Safer Supply and Opioid Agonist Treatment: A Narrative Review with Recommendations

“…In a retrospective chart review, those receiving buprenorphine ER had a lower rate of nonfatal opioid overdoses than those receiving methadone or buprenorphine-naloxone. 65 Patients who previously have had to attend a pharmacy daily report high satisfaction with depot buprenorphine [66][67][68][69][70] Another option that has limited availability in Canada is supervised injectable opioid agonist therapy (iOAT). There is good evidence that iOAT is effective for patients who have failed at an adequate trial of OAT.…”

Buprenorphine and its formulations: a comprehensive review

“…Reduction in these barriers to access and utilization may lead to greater efficacy in abstinence from non-prescribed opioid use, as prior studies have noted positive results with extended-use medicationassisted treatment. [30][31][32][33][34] Furthermore, this extended-release formulation has been shown to provide prolonged, therapeutic levels of buprenorphine up to eight weeks after subsequent injections, minimizing risks associated with missed doses and potentially improving treatment adherence. A comparison of the efficacy of the subcutaneous versus sublingual formulation revealed statistically significantly greater rates of opioid-negative urine samples in weeks 4-24.…”

Availability and prescribing of extended release buprenorphine injection for Medicaid beneficiaries, 2018-2022

“…(5) There is no risk of misuse or diversion, reduced burden of daily medication, and, for some individuals, a periodic injection may reduce negative effects of stigma associated with opioid agonist treatment. (6)(7)(8) Medicaid is the largest payer for behavioral health treatment, including OUD treatment, in the…”