{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T12:17:33Z","timestamp":1788524253133,"version":"build-2803163510"},"reference-count":37,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Buprenorphine is an effective yet underused treatment for opioid use disorder (OUD).<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the feasibility (acceptability, tolerability, and safety) of 7-day injectable extended-release buprenorphine in patients with minimal to mild opioid withdrawal.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This nonrandomized trial comprising 4 emergency departments in the Northeast, mid-Atlantic, and Pacific geographic areas of the US included adults aged 18 years or older with moderate to severe OUD and Clinical Opiate Withdrawal Scale (COWS) scores less than 8 (minimal to mild), in which scores range from 0 to 7, with higher scores indicating increasing withdrawal. Exclusion criteria included methadone-positive urine, pregnancy, overdose, or required admission. Outcomes were assessed at baseline, daily for 7 days by telephone surveys, and in person at 7 days. Patient recruitment occurred between July 13, 2020, and May 25, 2023.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Injection of a 24-mg dose of a weekly extended-release formulation of buprenorphine (CAM2038) and referral for ongoing OUD care.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary feasibility outcomes included the number of patients who (1) experienced a 5-point or greater increase in the COWS score or (2) transitioned to moderate or greater withdrawal (COWS score \u226513) within 4 hours of extended-release buprenorphine or (3) experienced precipitated withdrawal within 1 hour of extended-release buprenorphine. Secondary outcomes included injection pain, satisfaction, craving, use of nonprescribed opioids, adverse events, and engagement in OUD treatment.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 100 adult patients were enrolled (mean [SD] age, 36.5 [8.7] years; 72% male). Among the patients, 10 (10.0% [95% CI, 4.9%-17.6%]) experienced a 5-point or greater increase in COWS and 7 (7.0% [95% CI, 2.9%-13.9%]) transitioned to moderate or greater withdrawal within 4 hours, and 2 (2.0% [95% CI, 0.2%-7.0%]) experienced precipitated withdrawal within 1 hour of extended-release buprenorphine. A total of 7 patients (7.0% [95% CI, 2.9%-13.9%]) experienced precipitated withdrawal within 4 hours of extended-release buprenorphine, which included 2 of 63 (3.2%) with a COWS score of 4 to 7 and 5 of 37 (13.5%) with a COWS score of 0 to 3. Site pain scores (based on a total pain score of 10, in which 0 indicated no pain and 10 was the worst possible pain) after injection were low immediately (median, 2.0; range, 0-10.0) and after 4 hours (median, 0; range, 0-10.0). On any given day among those who responded, between 29 (33%) and 31 (43%) patients reported no cravings and between 59 (78%) and 75 (85%) reported no use of opioids; 57 patients (60%) reported no days of opioid use. Improving privacy (62%) and not requiring daily medication (67%) were deemed extremely important. Seventy-three patients (73%) were engaged in OUD treatment on day 7. Five serious adverse events occurred that required hospitalization, of which 2 were associated with medication.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This nonrandomized trial of the feasibility of a 7-day buprenorphine injectable in patients with minimal to mild opioid withdrawal (COWS scores, 0-7) found the formulation to be acceptable, well tolerated, and safe in those with COWS scores of 4 to 7. This new medication formulation could substantially increase the number of patients with OUD receiving buprenorphine.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04225598<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.20702","type":"journal-article","created":{"date-parts":[[2024,7,8]],"date-time":"2024-07-08T11:01:40Z","timestamp":1720436500000},"page":"e2420702","source":"Crossref","is-referenced-by-count":30,"title":["Extended-Release 7-Day Injectable Buprenorphine for Patients With Minimal to Mild Opioid Withdrawal"],"prefix":"10.1001","volume":"7","author":[{"given":"Gail","family":"D\u2019Onofrio","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"Herring","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Highland General Hospital-Alameda Health System, Oakland, California"},{"name":"Department of Addiction Medicine, Highland General Hospital-Alameda Health System, Oakland, California"},{"name":"Department of Emergency Medicine, University of California, San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanmarie","family":"Perrone","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Hawk","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut"},{"name":"Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Samuels","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, David Geffen School of Medicine at the University of California, Los Angeles"},{"name":"Department of Emergency Medicine, the Warren Alpert Medical School, Brown University, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Cowan","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Highland General Hospital-Alameda Health System, Oakland, California"},{"name":"Department of Addiction Medicine, Highland General Hospital-Alameda Health System, Oakland, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"McCormack","sequence":"additional","affiliation":[{"name":"Ronald O. 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