Only 1 in 3 Opioid Use Disorder Facilities Offer Buprenorphine Injections

Medications for opioid use disorder (MOUDs), including buprenorphine, save lives among people with opioid use disorder (OUD). Long-lasting injectable versions offer the same benefits and can help patients adhere to medication schedules.

Despite injectable buprenorphine’s benefits, a new study published in JAMA found that the class of drugs is only available at one-third of substance use treatment facilities.

The study analyzed data from the National Substance Use and Mental Health Services Survey collected between 2021 and 2022 to determine which brick-and-mortar substance use and mental health care facilities offered MOUDs or injectable buprenorphine.

Providers use injectable buprenorphine to treat certain patients who have moderate-to-severe OUD and have started treatment with another form of buprenorphine for at least seven days. The injectable is available in two dosages, one administered once a week and another administered once a month.

Sublocade, the first monthly injectable buprenorphine product, was approved by the FDA in 2017.

“Everyone who seeks treatment for opioid use disorder deserves the opportunity to be offered the treatment best suited to the needs of each individual patient, in combination with counseling and psychosocial support, as part of a comprehensive recovery plan,” FDA Commissioner Dr. Scott Gottlieb said in a statement.

The study results determined that while 61.9% of the studied facilities offered MOUDs, only 32.6% offered injectable buprenorphine.

A laundry list of hurdles may be preventing more providers from offering the drugs.

Facilities must administer buprenorphine injectables within 14 days of receiving them, the study’s authors said. The timeline means staying stocked with the drug can be difficult, and also requires staff to manage supply.

Facilities that offer the drug are also required to register with the FDA, adding administrative burdens.

Lastly, prior authorizations are required for more than a third of Medicaid formularies (compared to only 5% for other buprenorphine products).

Other types of medications have also become available in injectable products.

Injectable antipsychotic medications not only help patients adhere to medication schedules, but they also lead to fewer side effects. Some long-lasting injectable psychotics can last three months.

Facilities that offer injectable antipsychotic medications are more likely to also offer injectable buprenorphine, the study found, possibly because existing workflows could make the process of providing buprenorphine easier.

The study’s authors said steps should be taken to make injectable formulations available.

“Additional strategies to increase [long-acting injectable] buprenorphine uptake, including increasing access in primary care settings now that the 8-hour X-waiver training to prescribe buprenorphine has been eliminated, could expand availability and warrant further investigation,” the authors said.

While too few brick-and-mortar providers currently offer the drug, digital SUD treatment provider Bicycle partnered with retail giant Albertsons to make injectable buprenorphine Sublocade available at 700 pharmacies.

“Many patients prefer injections over taking pills orally every day,” Ankit Gupta, CEO and founder of Bicycle Health, told Addiction Treatment Business in an email. “People with opioid use disorder now have another effective option that may be more appropriate and convenient for their long-term recovery.”