Successful Treatment of Opioid Dependence with Flexible Doses of Injectable Prolonged Release Buprenorphine

Abstract

Opioid dependence (OD) may be effectively treated with well-evidenced regimens including psychosocial and pharmacotherapeutic interventions. Treatment has benefits but also limitations including risk of diversion, impact of mandatory daily supervision, and stigma. An injectable prolonged release buprenorphine with flexible dose options has recently been approved by the European Commission and is available in the UK and other European Countries. Initial positive treatment experience in patients with different clinical scenarios (patients with no recent treatment history, a transfer from oral methadone, and change from sublingual buprenorphine tablets) provides evidence of the potential benefit in a range of situations for this therapeutic option. Adoption of the injectable form was clinically successful with no withdrawal signs, nor evidence of use of other drugs. Patient reported outcomes were positive including reduction in cravings and anxiety and improved attitude, relationships, and general mood.

<p>Patient-Reported Outcomes, Experiences and Satisfaction with Weekly and Monthly Injectable Prolonged-Release Buprenorphine</p>

“…A structured interview guide was developed following validated examples 18 and published case studies describing PRB treatment outcomes. 19 The guide provided a detailed description of the interview to ensure consistency during discussions. The initial section of the guide focused on satisfaction with PRB treatment, the second section of the guide focused on recovery status.…”

Long-acting injectable buprenorphine for opioid use disorder: A systematic review of impact of use on social determinants of health

“…Most participants (approximately 60%) were male and of Caucasian ethnicity (>50%), with the remainder comprising other ethnic backgrounds including Asian, Black, Hispanic, and Latino. Occupational status was not consistently reported across all studies; however, for those that did, employment (full or part-time) ranged from 32% to 56% (D'Agnone, 2019;Frost et al, 2019;Gilman et al, 2018;Haight et al, 2019;Larance et al, 2020;Ling et al, 2019Ling et al, , 2020Lofwall et al, 2018;Saunders et al, 2020).…”

“…Seven studies (D'Agnone, 2019;Farahmand et al, 2020;Frost et al, 2019;Haight et al, 2019;Ling et al, 2019Ling et al, , 2020Lofwall et al, 2018) reported on outcomes of LAIB treatment. Eight studies evaluated LAIBnaïve participants' perspectives (Gilman et al, 2018;Larance et al, 2020;Neale et al, 2018aNeale et al, , 2018bNeale et al, , 2019aNeale et al, , 2019bSaunders et al, 2020;Tompkins et al, 2019).…”

“…The study divided abstinence as a theme into subcategories of: (1) reduction or cessation of illicit opioid use; (2) cravings; and (3) treatment satisfaction of LAIB, as these were considered important elements in identifying an individual's ability to have their clinical and psychosocial needs met and engage in an MAT program. Fourteen out of the 15 studies examined abstinence (D'Agnone, 2019;Farahmand et al, 2020;Frost et al, 2019;Gilman et al, 2018;Haight et al, 2019;Larance et al, 2020;Ling et al, 2019Ling et al, , 2020Lofwall et al, 2018;Neale et al, 2018aNeale et al, , 2018bNeale et al, , 2019bSaunders et al, 2020;Tompkins et al, 2019).…”

“…Thirteen studies directly discussed opioid reduction or cessation (D'Agnone, 2019;Farahmand et al, 2020;Frost et al, 2019;Gilman et al, 2018;Haight et al, 2019;Larance et al, 2020;Ling et al, 2020;Lofwall et al, 2018;Neale et al, 2018aNeale et al, , 2018bNeale et al, 2019b;Saunders et al, 2020;Tompkins et al, 2019). Gilman et al (2018) described abstinence from illicit substances as the most common goal for engaging in MAT.…”