Extended-Release Injection vs. Sublingual Buprenorphine for Opioid Use Disorder Among Persons Actively Using Illicit Opioids: A Randomized Clinical Trial

Authors: Joshua D. Lee, M.D., M.Sc.; Paul Joudrey, M.D., M.P.H.; Marc Larochelle, M.D., M.P.H.; Daniel Schatz, M.D.; Ayana Jordan, M.D., Ph.D.; Evan D. Behrle, B.A.; David P. Pennington, Ph.D.; Kevin Fiscella, M.D., M.P.H.; Babak Tofighi, M.D., M.Sc.; Noa Krawczyk, Ph.D.; Courtney Lenard, Ph.D.; Elie A. Akl, M.D., Ph.D.; Alexander Y. Walley, M.D., M.Sc.

Access to the article can be found here:  
JAMA Network Open: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2820306

This randomized clinical trial compared the effectiveness of extended-release injectable buprenorphine (XR-BUP) to daily sublingual buprenorphine-naloxone (SL-BUP/NX) in individuals actively using illicit opioids, including fentanyl. The study assessed treatment retention, reductions in illicit opioid use, and safety outcomes. Findings suggest that XR-BUP significantly improves treatment retention compared to SL-BUP/NX, making it a promising option for individuals struggling with adherence to daily medications. However, both treatments effectively reduced illicit opioid use with no major differences between the two groups in that measure.