Transition to Extended-Release Buprenorphine Injectable Within Seven Days for Opioid Use Disorder Treatment: A Scoping Narrative

Transition to Extended-Release Buprenorphine Injectable Within Seven Days for Opioid Use Disorder Treatment: A Scoping Narrative

Published: July/August 2025
Journal Article

Overview

This one-hour, on-demand, journal article-based activity explores the use of buprenorphine to treat opioid use disorder while considering risks and potential disengagement. This article focuses on the transition to extended-release or long-acting buprenorphine to improve outcomes and treatment adherence.

The target audience for this intermediate continuing education activity includes: physicians, nurse practitioners, physician assistants, pharmacists and other clinicians, researchers, students, and policymakers.

This activity addresses the following ACGME Core Competencies: Patient Care, Medical Knowledge, Practice-based Learning and Improvement, and Systems-Based Practice  

Abstract

Aims 

For patients with opioid use disorder, Sublocade (extended-release buprenorphine; Bup-XR-S) and Buvidal/Brixadi (long-acting buprenorphine; Bup-LA-B) formulations allow for less frequent dosing. Traditional induction with Bup-XR-S requires seven or more days on transmucosal buprenorphine can delay care and increase disengagement risk. Quicker transition to Bup-XR-S or Bup-LA-B presents a promising strategy. With the prevalence of potent illicit opioids, stabilization within seven days is critical to prevent overdose and withdrawal. This narrative review assesses outcomes of transitions to long-acting injectable buprenorphine within seven days of the last sublingual dose.

Methods

A systematic search of MEDLINE and EMBASE was completed through February 14, 2025. Studies involving patients with opioid use disorder who underwent Bup-XR-S and Bup-LA-B transition were included. Data on patient characteristics, buprenorphine dosing, retention rates, and outcomes were extracted and synthesized.

Results

We identified 21 studies, totaling 534 patients, that met our inclusion criteria. For Bup XR-S studies, 75 patients transitioned to Bup-XR-S within 24 hours. Four percent of patients experienced withdrawal symptoms requiring additional opioid support. All Bup-LA-B studies reported transitions within 24 hours. Short-term retention (four weeks) exceeded 60%. Adverse events were infrequent and primarily mild, including injection site pain, nausea, and constipation.

Conclusion

Limited descriptive studies suggest transitioning to Bup-XR-S within seven days appears feasible, well-tolerated, and supports treatment adherence. Following labelled dosing, Bup-LA-B transitions within 24 hours were effective and well-tolerated.  While these approaches may help initiate opioid agonist therapy in high-risk populations and mitigate overdose risks, further research is needed to confirm effectiveness and impact on retention.

Learning Objectives

Upon completion of this activity, learners will be able to:

1. Recognize the clinical and logistical factors driving interest in earlier transitions from sublingual buprenorphine to extended-release (Bup-XR-S) or long-acting injectable (BUP-LA-B) formulations for patients with opioid use disorder. 
2. Identify clinical factors, including flexible induction strategies and rapid stabilization, that support improved patient outcomes and treatment adherence when transitioning to long-acting injectable buprenorphine formulations. 
3. Apply insights from early transition protocols to inform decision-making when initiating Bup-XR-S or Bup-LA-B in clinical practice. 

Registration Rates

*Residents, Fellows-in-training, Interns, and Students must join ASAM to receive a discounted registration rate. Click here to become an ASAM member. National and Chapter membership dues apply. There is no charge for Students to become a Member, but verification of student status is required.

Membership Question?  Call ASAM at 1.301.656.3920, email us, or view the ASAM website for more information.

Refunds & Cancellations

All ASAM eLearning Center refund requests must be made in writing to education@asam.org within 90 days of purchase. Those requesting refunds for courses that are in progress will receive partial refunds or eLearning Center credit. Automatic full refunds will be made for any course with a live-course component that has been canceled.

Open Registration: 07/30/2025 - 02/03/2028

Close Access Date: 02/03/2028

Course Instructions

1. Click on the Contents tab to begin this activity.
2. Click Download Journal Article in the box titled Journal Article and read the journal article in its entirety. 
3. Click Complete Post-Test to answer multiple-choice questions. Participants will have 10 attempts to pass and must answer 2 out of 3 questions correctly.
4. Click Complete Evaluation to provide valuable activity feedback. Scroll down on all questions, as there may be answer options that expand past the size of the window.
5. Click the button Claim Medical Credits in the box titled Claim Credits & Certificate. Choose the type of credit and click submit. Click the button View/Print Certificate to save or print your certificate. You can view/print your certificate at any time by visiting the ASAM eLearning Center, clicking Dashboard, and clicking Transcript/Achievements.

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Accreditation & Credits

Joint Accreditation Statement

In support of improving patient care, the American Society of Addiction Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credits Available

• Physicians: 1.00 Credit
• Nurses & NPs: 1.00 Nursing Contact Hour
• PAs: 1.00 Credit
• Pharmacology Hour: 1 Hour
  
• Interprofessional Continuing Education: 1.00 Credit
• Certified Counselors: NBCC Contact Hours Not Offered

  

  American Society of Addiction Medicine has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7062. Programs that do not qualify for NBCC credit are clearly identified. American Society of Addiction Medicine is solely responsible for all aspects of the programs.

Maintenance of Certification (MOC)/Continuing Certification Program (CCP)

This activity is designed to meet the requirements for MOC/CCP for several primary physician boards and for state licensing CME requirements. MOC Credit is only reported and designated for ABA, ABP, ABIM, and ABS. By completing the online credit application and evaluation, the learner permits ASAM to report credits to the appropriate Board. Learn more.

• ABIM MOC Points: 1.00 Medical Knowledge
• ABP MOC: 1.00 Lifelong Learning & Self-Assessment
• ABS Continuing Certification: 1.00 Accredited CME
• ABA MOCA 2.0®*: 1.00 Lifelong Learning MOCA 2.0® is a trademark of the American Board of Anesthesiology®. This activity contributes to the CME requirement for Part II: Lifelong Learning and Self-Assessment of the American Board of Anesthesiology's (ABA) redesigned Maintenance of Certification in Anesthesiology Program® (MOCA®), known as MOCA 2.0®. Please consult the ABA website, https://www.theaba.org/, for a list of all MOCA 2.0 requirements.

Additionally, this activity has been designed to satisfy the requirements of the following primary physician board certification requirements. Please confirm with your individual Board.

• American Board of Addiction Medicine (ABAM)
• American Board of Preventive Medicine (ABPM)
• American Board of Psychiatry and Neurology (ABPN)
• Royal College of Physicians and Surgeons of Canada (RCPSC)

Certificates for other professions

All participants may request a certificate of participation upon completion of the activity and an online evaluation confirming their participation. Learners are strongly advised to contact their professional licensing board or professional association to confirm this certificate will be accepted as evidence supporting continuing education requirements.

California Association for Drug/Alcohol Educators (CAADE)

This educational program is approved by CAADE: #CP40 999 1225.

California Association of DUI Treatment Centers (CADTP)

This educational program is approved by CADTP: #205.

California Consortium of Addiction Programs and Professionals (CCAPP)

This educational program is approved by CCAPP: #OS-20-330-0227.

Disclosure Information

In accordance with the disclosure policies of ASAM and Joint Accreditation, the effort is made to ensure balance, independence, objectivity, and scientific rigor in all accredited continuing education activities. These policies include identifying and mitigating all relevant financial relationships with ineligible companies for those involved in the creation and dissemination of accredited continuing education. 

See the attached article and pdf for a list of disclosures