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Case Series: Rapid Induction Onto Long Acting Buprenorphine Injection for High Potency Synthetic Opioid Users
John J Mariani1,2, Amy Mahony1, Muhammad N Iqbal1
1Division on Substance Use Disorders, New York State Psychiatric Institute, New York, New York.
Background And Objectives:
Highly potent synthetic opioids (HPSO) are increasingly responsible for opioid overdose deaths in the United States.
Methods:
In an open-label, uncontrolled trial to test the feasibility of extended-release buprenorphine (BXR) injection treatment of heroin-using individuals with opioid use disorder testing positive for HPSO, participants were enrolled and began an induction with sublingual BXR (n = 5). During the induction, ancillary medications (clonidine, clonazepam, zolpidem, and prochlorperazine) were provided for breakthrough opioid withdrawal symptoms.
Results:
Two participants received the BXR injection on the second day of the induction and three participants on the third day.
Discussion And Conclusion:
All five participants were retained at least 1-month postinduction.
Scientific Significance:
It may be feasible to provide BXR treatment to HPSO-positive heroin users rapidly to achieve clinical stabilization. (Am J Addict 2020;00:00-00).
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