Buprenorphine

Buprenorphine is taken as a once daily or twice daily dissolvable tablet or film. Because individuals are initiated on buprenorphine for the first time when they are experiencing opioid withdrawal symptoms, programs that support implementation tend to focus on settings where individuals present with opioid withdrawal symptoms, such as hospitals or prisons and jails.

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 is available in many different forms but is most commonly a tablet or film that dissolves under the tongue. People can take different doses of buprenorphine depending on their individual needs. Buprenorphine is also available as a longer-acting injection or implant under the skin. Buprenorphine is sometimes combined with naloxone to prevent the medication from being abused. This type of naloxone is different than the naloxone used to reverse opioid overdoses. Individuals begin taking buprenorphine for the first time (a process called induction or initiation), after which they can continue to take the medication at home regularly. Programs that seek to “implement” buprenorphine tend to focus on supporting healthcare providers with the necessary knowledge and workflows to safely prescribe buprenorphine to patients for the first time.