Name of the Procedure:

• Common Name: Buprenorphine Injection
• Technical/Medical Term: Injection, buprenorphine extended-release (Sublocade), greater than 100 mg (Q9992).

Summary

This procedure involves administering an extended-release injection of buprenorphine, a medication used to treat opioid dependence. The injection is typically delivered under the skin and slowly releases the medication over time to help manage withdrawal symptoms and reduce cravings.

Purpose

• Medical Conditions: Opioid dependence
• Goals: To provide long-lasting relief from opioid withdrawal symptoms and cravings, stabilize the patient's condition, and support recovery from opioid addiction.

Indications

• Symptoms/Conditions: Patients with moderate to severe opioid use disorder who have already initiated treatment with a transmucosal buprenorphine-containing product.
• Patient Criteria: Individuals who have been opioid-free for at least 7 days and are deemed appropriate candidates for extended-release buprenorphine by their healthcare provider.

Preparation

• Pre-procedure Instructions:
  • Ensure the patient has been opioid-free for at least 7 days.
  • May involve initial treatment with a transmucosal buprenorphine product to determine tolerance.
  • Verify the patient's general health and ongoing recovery efforts.
• Diagnostic Tests/Assessments: Comprehensive medical history and physical examination; potential urine drug screening.

Procedure Description

1. The injection is typically administered once a month.
2. The site is usually the abdominal area, specifically subcutaneously (under the skin).
3. The healthcare provider prepares a sterile injection site.
4. The extended-release formulation of buprenorphine is injected using a pre-filled syringe.
5. No general anesthesia is required; local anesthetic cream might be used to numb the injection site.

Duration

• The injection itself takes only a few minutes to administer.

Setting

• This procedure is typically performed in an outpatient clinic or healthcare provider’s office.

Personnel

• The injection is administered by healthcare professionals such as a doctor, nurse practitioner, or physician assistant.

Risks and Complications

• Common Risks: Pain at the injection site, redness, swelling, and irritation.
• Rare Risks: Serious allergic reactions, infection at the injection site, liver problems, respiratory depression.
• Management: Most risks are manageable with proper medical care and monitoring.

Benefits

• Expected Benefits: Reduced opioid cravings, stabilization of withdrawal symptoms, improved adherence to recovery programs.
• Realization Time: Benefits can often be noticed within days, with continuous improvement over the month.

Recovery

• Post-procedure Care: Minimal; monitor the injection site for signs of infection or adverse reactions.
• Recovery Time: Patients can typically resume normal activities immediately; follow-up appointments are scheduled monthly.

Alternatives

• Other Options:
  • Transmucosal buprenorphine products (sublingual tablets, films).
  • Methadone maintenance therapy.
  • Naltrexone extended-release injection.
• Pros and Cons:
  • Transmucosal buprenorphine: Daily dosing required, more flexible but less consistent levels.
  • Methadone: Effective but requires daily supervised dosing at a clinic.
  • Naltrexone: Non-opioid option, requires complete detoxification before initiation.

Patient Experience

• During Procedure: Minor discomfort during the injection.
• After Procedure: Possible soreness at the injection site; otherwise, minimal disruption to daily life.
• Pain Management: Over-the-counter pain relievers can be used if needed.