Buprenorphine

Buprenorphine is typically initiated for the first time when someone is experiencing opioid withdrawal symptoms, after which it is taken regularly to prevent further withdrawal symptoms. It is common for an individual to stop and restart buprenorphine multiple times during their treatment journey.

Evidence for the intervention

Evidence supporting opioid overdose education and naloxone distribution (OEND) programs is summarized in at least eight systematic reviews. These draw mostly from observational study designs, including case series, cohort studies, and quality improvement studies. There are very few randomized controlled trials evaluating OEND programs, largely due to the overwhelming body of real-world evidence supporting naloxone distribution; this is common for interventions with substantial face-value credibility, such as parachutes or epinephrine pens. The few existing randomized controlled trials of OEND programs tend to compare one OEND implementation strategy to another OEND implementation strategy

Evidence-based Scale

Buprenorphine can work at any point in an individual’s treatment journey, including after an overdose or during recovery, but the individual must be willing to take a daily medication rather than continue using other opioids. Buprenorphine is typically started for the first time (a process called induction or initiation) when a person is already experiencing symptoms of opioid withdrawal in a clinical setting such as a hospitalization or incarceration, although there are other ways of starting someone on buprenorphine such as home induction and micro induction. Like other treatments for chronic medical conditions, it is common for individuals to stop and restart buprenorphine multiple times during their treatment journey. Unlike naltrexone, a medication used to treat OUD that prevents opioids from exerting their effects, an individual does not need to undergo a prolonged period of opioid abstinence or detoxification from opioids before starting methadone.