Name of the Procedure:

Injection, buprenorphine extended-release (Sublocade), less than or equal to 100 mg (Q9991)

Summary

Buprenorphine extended-release injection, known as Sublocade, is a monthly injection used to treat opioid use disorder. It releases buprenorphine gradually to help reduce cravings and withdrawal symptoms.

Purpose

Medical Conditions Addressed

• Opioid use disorder.

Goals and Expected Outcomes

• To reduce opioid cravings and withdrawal symptoms.
• To support long-term recovery by maintaining opioid abstinence.

Indications

• Patients diagnosed with moderate to severe opioid use disorder.
• Individuals who have already started treatment with a transmucosal buprenorphine product and have achieved clinical stability.

Preparation

Pre-procedure Instructions

• Patients should attend a consultation to confirm their candidacy.
• No specific fasting required.
• Adjustment of any concurrent medications should be discussed with the healthcare provider.

Pre-procedure Assessments

• Evaluation of opioid use disorder.
• Confirming stabilization with a transmucosal buprenorphine product.

Procedure Description

Steps Involved

1. Patient Preparation: The patient is positioned comfortably.
2. Injection Site Selection: The healthcare provider selects an appropriate site on the abdomen.
3. Disinfection: The injection site is cleaned with an antiseptic solution.
4. Injection: Using a pre-filled syringe, the healthcare provider injects Sublocade subcutaneously into the abdominal area.

Tools and Equipment

• Pre-filled syringe containing Sublocade.
• Antiseptic wipes.

Anesthesia or Sedation

• Generally, no anesthesia or sedation is required.

Duration

• The injection procedure typically takes about 10-15 minutes.

Setting

• Conducted in a clinical setting such as an outpatient clinic or a healthcare provider's office.

Personnel

• Administered by a trained healthcare provider such as a nurse or physician.

Risks and Complications

Common Risks

• Injection site reactions (e.g., pain, redness, itching).
• Nausea.

Rare Risks

• Respiratory depression.
• Allergic reactions.

Management of Complications

• Medical intervention in the case of severe allergic reactions or respiratory issues.

Benefits

• Provides consistent and long-acting relief from opioid cravings and withdrawal.
• Supports maintenance of opioid abstinence.
• Benefits are typically realized within the first few days after the injection.

Recovery

Post-procedure Care

• Report any severe or persistent side effects to a healthcare provider.
• Follow normal daily activities unless advised otherwise.

Expected Recovery Time

• Minimal to no downtime required.
• Follow-up appointments scheduled monthly.

Alternatives

Other Treatment Options

• Transmucosal buprenorphine products (tablets or films).
• Methadone maintenance treatment.
• Naltrexone injection (Vivitrol).

Pros and Cons of Alternatives

• Transmucosal products require daily dosing and adherence can be challenging.
• Methadone requires frequent clinic visits but offers flexible dosing.
• Naltrexone is non-addictive but requires complete detoxification before starting treatment.

Patient Experience

• During the procedure, patients may feel mild discomfort at the injection site.
• After the procedure, there may be some minor pain or swelling at the injection site, which typically resolves within a few days.
• Pain management measures include applying ice to the injection site and using over-the-counter pain relievers as needed.