Buprenorphine is a first-line treatment for opioid use disorder, however, given buprenorphine to a patient who still has opioids in their system can precipitate severe withdrawal. Careful assessment of withdrawal can minimize the risk, but despite our best efforts, precipitated withdrawal can still occur. In this article, we review what to do for our patients experiencing buprenorphine-precipitated opioid withdrawal.

Long-acting buprenorphine is a promising new treatment for opioid use disorder, but it usually requires a seven-day stabilization period before initiation. Here, researchers develop and evaluate a novel protocol for initiating long-acting injectable buprenorphine in a single day. The trial is small, but results are promising.

All clinicians need to know how to use buprenorphine under the DEAs new regulations. Meanwhile, the fentanyl crisis is changing how we use it. Noah Capurso shows us how to navigate these waters.

Buprenorphine and methadone are both first-line treatments for opioid use disorder during pregnancy. Though this recommendation has been long-standing, it is based on a rather small study that is nearly 15 years old. In the current study, researchers revisit the question of how best to treat opioid use disorder during pregnancy with a large observational cohort study.

The last high-quality head-to-head comparison of buprenorphine and methadone during pregnancy was the MOTHER trial, which was published nearly 15 years ago. Here, researchers revisited the question of which medication is better to use in pregnancy in this large, carefully done, retrospective study. The results make a compelling case for buprenorphine. 

Incarcerated individuals with opioid use disorder are at an especially heightened risk of adverse outcomes.  The period immediately following release is a particularly vulnerable time, with a much elevated risk of fatal overdose. In this study, investigators report on the use of extended-release injectable buprenorphine in a correctional setting.

Pregnant patients with OUD may be reluctant to reveal their substance use for fear of losing their baby if reported to Child Protective Services. But this recent study shows that pregnant patients receiving medication treatment for OUD were more likely to leave the hospital with their baby than patients not receiving treatment.