Single-Dose, Long-Acting Injectable Buprenorphine for Opioid Withdrawal Treatment

Long-acting, injectable buprenorphine (LAIB) is a recently introduced opioid agonist treatment (OAT) for opioid dependence in Australia. Little research has been performed for its role in opioid withdrawal management.

A retrospective analysis of hospital patient records was conducted for five patients who received a single dose of LAIB as part of an inpatient or outpatient opioid withdrawal management program. Patients analysed had tried and failed conventional opioid withdrawal management and were unwilling to commence or continue an OAT program.

Patient demographics including types of opioid use and inpatient lengths of stay are reported. Patient withdrawal symptoms before treatment and during follow-up periods are also described. Overall, most patients were satisfied with a single dose of LAIB to adequately control withdrawal symptoms in the community.

Given the stability of OAT patients on LAIB, it was inferred that some patients may do well in opioid withdrawal management using LAIB, should other conventional treatments not succeed. This was based on previous pharmacokinetic data and modelling by others which would allow for a slow, in vivo wean of the drug rather than discrete, daily dose reductions. For patients, this could reduce potential withdrawal symptoms and shorten admission lengths in hospital withdrawal management wards. Further research is needed to verify these results, but these preliminary data are encouraging.