October 2024 Journal Club – Initiating MOUD Without Withdrawal: ED Trial of Injectable Buprenorphine (Brixadi) in Patients With Minimal Withdrawal

Precipitated withdrawal (PW) is a deterrent to initiating MOUD for both patients
and providers. Experiencing PW can turn an ambivalent patient further from
accepting medication, as can the need to experience withdrawal simply to start
treatment. Having a medication at the ready, without the need to wait for
withdrawal to ensue is of great appeal. In this multicenter study conducted in EDs,
investigators enrolled patients with minimal to mild opioid withdrawal, i.e., COWS
of 0-7, and gave them a dose of weekly injectable buprenorphine, CAM2038
(brand name Brixadi) at 24mg (16mg SL “equivalent”)- without prior sublingual
dosing. Woah.