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Language of Resource
Full Text Available
Open Access / OK to Reproduce
Peer Reviewed
Objective
Retrospective case series have raised concerns about increased incidence of precipitated withdrawal (PW) when buprenorphine is initiated in persons using fentanyl. We report the incidence of PW as part of an ongoing randomized clinical trial comparing traditional sublingual buprenorphine with CAM2038, a 7-day extended-release injectable form of buprenorphine, conducted in sites with high prevalence of fentanyl.
Findings/Key points
Despite high fentanyl prevalence, the incidence of PW in this multisite trial of ED-initiated buprenorphine was less than 1%, similar to reported rates among persons using heroin or prescription opioids. All 9 patients with PW used fentanyl, most without PW also used fentanyl, and no factors suggest a specific phenotype for PW. The discordance between our findings and those of retrospective studies is striking. In this geographically diverse observational cohort, buprenorphine induction in the ED remained safe and effective, even with fentanyl present. Continued access to buprenorphine for opioid use disorder treatment is essential given the ongoing overdose crisis.
Design/methods
Observational cohort study (n=1200)
