Outcomes of a single-arm implementation trial of extended-release subcutaneous buprenorphine depot injections in people with opioid dependence
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Date
2022
Authors
Farrell, M.
Shahbazi, J.
Byrne, M.
Grebely, J.
Lintzeris, N.
Chambers, M.
Larance, B.
Ali, R.
Nielsen, S.
Dunlop, A.
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Journal article
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International Journal of Drug Policy, 2022; 100:103492-1-103492-10
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Michael Farrell, Jeyran Shahbazi, Marianne Byrne, Jason Grebely, Nicholas Lintzeris, Mark Chambers, Briony Larance, Robert Ali, Suzanne Nielsen, Adrian Dunlop, Gregory J. Dore, Michael McDonough, Mark Montebello, Thomas Nicholas, Rob Weiss, Craig Rodgers, Jon Cook, Louisa Degenhardt, on behalf of the CoLAB study team
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Abstract
Background: Opioid agonist treatment (OAT) is an effective intervention for opioid dependence. Extended-release buprenorphine injections (BUP-XR) may have additional potential benefits over sublingual buprenorphine. This single-arm trial evaluated outcomes among people receiving 48 weeks of BUP-XR in diverse community health- care settings in Australia, permitting examination of outcomes when BUP-XR is delivered in standard practice. Methods: Participants were recruited from a network of specialist public drug treatment services, primary care and some private practices in three states. Following a minimum 7 days on 8–32 mg of sublingual buprenorphine (±naloxone), participants received monthly subcutaneous BUP-XR injections administered by a healthcare practitioner and completed monthly research interviews. The primary endpoint was retention in treatment at 48 weeks. Findings: Participants (n = 100) were 28% women, mean age 44 years with a long history of OAT (median 5.8 years); heroin was the most common opioid of concern (58%). Treatment retention at 24 and 48 weeks was 86% and 75%, respectively. Participants with past-month injecting drug use (OR 0.23; 95%CI: 0.09–0.61) or heroin use (OR 0.23; 95%CI: 0.08–0.65) at baseline had lower odds of being retained in treatment to 48 weeks. Reductions in multiple forms of extra-medical drug use were observed. Improvements in quality of life, participation in employment, and treatment satisfaction measures were also observed. Interpretation: This real-world implementation study of BUP-XR demonstrated high retention and treatment satisfaction. This study provides important additional data on the uptake and experience of clients, with relevance for policy makers, health service planners, administrators, and practitioners. Funding: Indivior. Trial registration: ClinicalTrials.gov Identifier: NCT03809143
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© 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)