{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T10:48:37Z","timestamp":1785754117064,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Methadone\u2010to\u2010buprenorphine transfers (MBT) are increasingly common as buprenorphine use expands. Evidence describing patient experience of withdrawal during MBT in real\u2010world populations is limited. This study aimed to characterise withdrawal trajectories during MBT and examine whether psychosocial and clinical factors influence the severity or timing of withdrawal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This analysis used data from a prospective, non\u2010randomised clinical trial comparing low\u2010dose and stop\u2010and\u2010start MBT techniques (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009117). Covariates included methadone dose, duration on methadone, transfer setting, study arm, withdrawal expectancy, psychological distress, substance use and unstable housing. Withdrawal was assessed daily using the Clinical Opioid Withdrawal Scale (COWS) and Short Opiate Withdrawal Scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety\u2010four participants (80.3%) completed transfer. Withdrawal followed a consistent trajectory across the cohort, peaking around Day 5. Psychosocial and clinical characteristics\u2014including unstable housing, substance use, psychological distress and methadone dose\u2014were not associated with withdrawal severity or timing. Compared with stop\u2010and\u2010start transfer, low\u2010dose transfer was associated with a delayed and larger increase in objective withdrawal: peak COWS occurred 2.3\u2009days later (95% CI 0.3\u20134.3) and the largest one\u2010day increase was 3.8 points higher (95% CI 0.5\u20137.0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and Conclusions<\/jats:title>\n                    <jats:p>Patient factors often considered barriers to MBT were not associated with withdrawal severity or timing. Low\u2010dose transfer was associated with a delayed and slightly higher withdrawal peak but did not reduce overall transfer success. These findings suggest that withdrawal during MBT follows a broadly similar trajectory across patients with differing psychosocial complexity. Planning for expected withdrawal, rather than selecting patients based on perceived complexity, may be more clinically relevant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dar.70211","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T04:45:08Z","timestamp":1784781908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Experience of Withdrawal During Methadone\u2013Buprenorphine Transfer: A Prospective Cohort Study"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-3342","authenticated-orcid":false,"given":"Chris","family":"Tremonti","sequence":"first","affiliation":[{"name":"Alcohol and Drug Services St Vincent's Hospital  Sydney Australia"},{"name":"Drug Health Services Sydney Local Health District  Sydney Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney 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