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Buprenorphine: Better Delivery=Better Results?

Research Tests Safety and Efficacy of Injectable vs Sublingual Formulations

Findings from a recent study suggest that rethinking the delivery mechanism for buprenorphine may enhance its effectiveness in treating opioid use disorder (OUD), now estimated to affect some 2.6 million American patients. The medication is typically delivered sublingually in the form of tablets or film, but these formulations have drawbacks that include risk for misuse or nonadherence, diversion, and danger of unwanted pediatric exposure. Researchers from the UK Center on Drug and Alcohol research studied the safety and efficacy of CAM2038, a fluid crystal depot buprenorphine therapy that can be delivered by weekly or monthly injection. The results were published in the Journal of the American Medical Association.

In the 6-month study, participants from 35 outpatient sites were randomized to receive either weekly or monthly buprenorphine injections and a daily sublingual placebo, or placebo buprenorphine injections and daily buprenorphine-naloxone tablets, the current standard of care. Researchers assessed the primary responder rate outcome, based on urine drug testing, and confirmed the efficacy of the injectable delivery approach. Study author Michelle Lofwall, MD, associate professor of Psychiatry at the UK Center commented “Together with the six-month buprenorphine implant, these new long-acting medication delivery systems would allow us to administer a proven medication to the patients directly, ensuring adherence, leading to improved medication efficacy as well as avoiding the potential for missed or stolen doses, diversion or accidental pediatric exposure, which are significant public health concerns.”

Read about the study findings.

The journal abstract may be read here.