The Use of Extended-Release Buprenorphine in the Treatment of Adolescent Opioid Use Disorder: A Case Series

Opioid use disorder (OUD) is rising among adolescents, highlighting a need for additional treatment approaches in this population. Buprenorphine, a medication for opioid use disorder, is available in multiple formulations. Sublingual buprenorphine is approved for use in patients ages 16 and older. Extended-release buprenorphine is approved only for adults, and studies have not established the safety and efficacy of its use in adolescents younger than age 18. This case series reviews the medical records of adolescents with OUD receiving monthly extended-release buprenorphine subcutaneous injections.

The electronic medical records of six adolescents, younger than 18 years, receiving monthly extended-release buprenorphine in an outpatient setting from February 2022 to April 2024 were reviewed. The primary outcomes of interest were treatment retention, complications, and opioid abstinence during treatment.

The patients included in this case series ranged in age from 15 to 17 years at the onset of treatment. The majority of patients, four of the six, were female. At the conclusion of the chart review period in April 2024, all six patients remained on treatment with extended-release buprenorphine. The duration of treatment with extended-release buprenorphine varied among patients from 2 to 13 months. No significant complications were noted. Five patients achieved opioid abstinence for greater than 2 months during treatment.

Treatment of OUD in adolescents remains challenging. This case series highlights a need for larger studies to establish the safety and efficacy of extended-release buprenorphine in adolescents younger than 18 years of age.