{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:39:46Z","timestamp":1792067986571,"version":"4.4.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Buprenorphine is an effective treatment for opioid use disorder, but it can be challenging to avoid withdrawal in the process of buprenorphine initiation. After the recent FDA approval of 7-day long-acting injectable buprenorphine, some clinicians have used this formulation to start patients on buprenorphine without a prior sublingual \u201ctest dose.\u201d Very little is known about the feasibility of this practice in an outpatient setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases:<\/jats:title>\n                    <jats:p>In this case series, we conducted a retrospective chart review of electronic health record data for all patients who were ordered 7-day long-acting injectable buprenorphine for a \u201cdirect-to-inject\u201d initiation within a single public health system from January 1, 2024 to November 15, 2024. We excluded patients who received a cumulative dose of 4\u2009mg or more of sublingual buprenorphine in the 24\u2009hours before injection. We reported on chart-documented patient experiences after injection, whether patients returned to care, and retention on buprenorphine at 7- and 30-days post-injection. We identified 21 unique patients who received direct-to-inject buprenorphine in 22 attempts. In 17 (77%) attempts, the patient received no buprenorphine in the preceding 24\u2009hours. In 5 (23%) attempts, patients received some buprenorphine in the preceding 24\u2009hours (&lt;4\u2009mg) and\/or had evidence of buprenorphine in a same-day urine drug screen. Patient experiences post-injection fit into 1 of 3 themes: \u201cIt felt fine\u201d (n\u2009=\u20096), \u201cI felt unwell but okay\u201d (n\u2009=\u200913), and \u201cIt felt very rough\u201d (n\u2009=\u20093). Most attempts resulted in buprenorphine treatment retention at 7\u2009days (n\u2009=\u200917, 77%) and 30\u2009days (n\u2009=\u200916, 73%) after injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>Direct-to-inject buprenorphine was generally well tolerated, with excellent retention on buprenorphine at 7- and 30 days post-injection. Further research is needed to evaluate the correlation between preinjection patient characteristics (time since last use, level of withdrawal) and post-injection patient experience of withdrawal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342251330412","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T07:19:57Z","timestamp":1743751197000},"page":"1064-1069","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["Outpatient Initiation of 7-Day Injectable Buprenorphine: A Direct-to-Inject Case Series"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2885-9605","authenticated-orcid":false,"given":"Sarah","family":"Rosenwohl-Mack","sequence":"first","affiliation":[{"name":"Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-356X","authenticated-orcid":false,"given":"Leslie W.","family":"Suen","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-678X","authenticated-orcid":false,"given":"Alexander A.","family":"Logan","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine at San Francisco General Hospital, Department of Medicine, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6670-0726","authenticated-orcid":false,"given":"Damian","family":"Peterson","sequence":"additional","affiliation":[{"name":"San Francisco Department of Public Health, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8120-3824","authenticated-orcid":false,"given":"Hannah R.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1550"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13722-021-00244-8"},{"key":"e_1_3_3_4_2","unstructured":"CDC National Center for Health Statistics. Vital statistics rapid release\u2014provisional drug overdose data. November 4 2024. Accessed November 19 2024. https:\/\/www.cdc.gov\/nchs\/nvss\/vsrr\/drug-overdose-data.htm"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001155"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40267-024-01055-y"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.20702"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40261-021-01032-7"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/10398562241237655"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000001104"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.3928\/00485713-20201008-01"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2212412"},{"key":"e_1_3_3_13_2","unstructured":"Brixadi Prescribing Information. Braeburn Inc. Plymouth Meeting PA 19462. Published online December 2023."},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-024-00998-9"}],"container-title":["Substance Use &amp; Addiction Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251330412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/29767342251330412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/29767342251330412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T01:51:05Z","timestamp":1777600265000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/29767342251330412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,4]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/29767342251330412"],"URL":"https:\/\/doi.org\/10.1177\/29767342251330412","relation":{},"ISSN":["2976-7342","2976-7350"],"issn-type":[{"value":"2976-7342","type":"print"},{"value":"2976-7350","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,4]]}}}