{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T02:47:59Z","timestamp":1790909279419,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T00:00:00Z","timestamp":1738454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R18 HS029774\u201001"],"award-info":[{"award-number":["R18 HS029774\u201001"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>When administered as prescribed, the naloxone component of buprenorphine\u2010naloxone combination medications is putatively considered inert due to reduced naloxone bioavailability via transmucosal. However, there is a growing body of evidence to the contrary. The aim of our study is to determine the extent of naloxone absorption in a large cohort of patients receiving sublingual buprenorphine\u2010naloxone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Mayo Clinic Unified Data Platform, 425 patients prescribed sublingual buprenorphine\/naloxone who received a controlled substance monitoring panel (CSMP) between January 1, 2022, and January 1, 2023 were identified and included. The CSMP is an immunoassay panel that confirms positive results quantitatively with gas chromatography mass spectrometry or liquid chromatography tandem mass spectrometry. This panel provides urinary detection for buprenorphine (cutoff: 5\u2009ng\/mL), naloxone (25\u2009ng\/mL), as well as their respective metabolites norbuprenorphine (5\u2009ng\/mL), norbuprenorphine\u2010glucuronide (20\u2009ng\/mL), and naloxone\u2010glucuronide (100\u2009ng\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of our 425 patients, 76% had norbuprenorphine (<jats:italic>n<\/jats:italic>\u2009=\u2009323), and 77% had norbuprenorphine\u2010glucuronide (<jats:italic>n<\/jats:italic>\u2009=\u2009327) in their toxicology tests, respectively. Naloxone\u2010glucuronide was detected in 91% (<jats:italic>n<\/jats:italic>\u2009=\u2009294) of the specimens with norbuprenorphine and 88.7% (<jats:italic>n<\/jats:italic>\u2009=\u2009290) of the specimens with norbuprenorphine\u2010glucuronide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Scientific Significance<\/jats:title><jats:p>To our knowledge, this is the largest study to date demonstrating the presence of naloxone metabolites in patients taking combined buprenorphine\u2010naloxone medications. The results of this study refute the notion that naloxone absorption is negligible when administered in sublingual preparations. Further research on how this absorption impacts medication usage, dosing, adherence, and side effects is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajad.13674","type":"journal-article","created":{"date-parts":[[2025,2,2]],"date-time":"2025-02-02T10:54:36Z","timestamp":1738493676000},"page":"350-354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Absorption of naloxone in patients prescribed buprenorphine\u2010naloxone"],"prefix":"10.1111","volume":"34","author":[{"given":"Ian","family":"Michel","sequence":"first","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4494-9981","authenticated-orcid":false,"given":"Domenic","family":"Ochal","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aniket","family":"Paharia","sequence":"additional","affiliation":[{"name":"Tulane University School of Medicine, Tulane University New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Jannetto","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Breitinger","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7363-8086","authenticated-orcid":false,"given":"Tyler","family":"Oesterle","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,2]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"NIDA. 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