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Characterizing withdrawal from long-acting injectable buprenorphine: An observational case series
Victoria Hayes1, Llewellyn Mills1,2,3, Gaye Byron4
1Drug and Alcohol Services, South Eastern Sydney Local Health District, New South Wales, Australia.
Drug and Alcohol Dependence Reports
|April 25, 2025
Summary
Long-acting injectable buprenorphine (LAIB) treatment discontinuation resulted in mild withdrawal symptoms, peaking 5-8 weeks post-dose. Further trials comparing LAIB, sublingual buprenorphine, and methadone are needed.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Research
Background:
- Long-acting injectable buprenorphine (LAIB) is increasingly used for opioid dependence treatment.
- Limited data exists on withdrawal severity and timing after LAIB discontinuation.
Purpose of the Study:
- To assess withdrawal signs and symptoms following discontinuation of long-term LAIB treatment.
- To evaluate the duration and severity of withdrawal symptoms after the final LAIB dose.
Main Methods:
- Participants discontinuing monthly 64 mg Buvidal® were monitored for 16 weeks post-dose.
- Weekly assessments included withdrawal severity (COWS), cravings, general health, and patient experience.
Main Results:
- Fifteen participants completed at least four weeks of follow-up.
- Minimal withdrawal increase observed, with average peak COWS score of 4.8 at 6 weeks.
- Low cravings, stable health scores, and high patient satisfaction were reported.
Conclusions:
- Discontinuation of Buvidal® 64 mg Monthly led to mild withdrawal, peaking 5-8 weeks after the last dose.
- Results suggest a manageable withdrawal profile for LAIB.
- Comparative clinical trials are necessary to inform treatment decisions regarding LAIB, sublingual buprenorphine, and methadone.
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