Recent advances in the treatment of opioid use disorders–focus on long-acting buprenorphine formulations

Abstract

Oral methadone or sublingual buprenorphine are first-line medications for pharmacotherapy of opioid use disorders (OUDs). Three long-acting buprenorphine depot or implant formulations are currently available for the treatment of OUDs: (1) CAM 2038 (Buvidal) for subcutaneous weekly and monthly application; (2) RBP-6000 (Sublocade™) as a monthly depot formulation; and (3) A six-month buprenorphine implant [Probuphine™]. The pharmacology, clinical efficacy and prospects of these medications are discussed.

Keywords: Opioids; Opioid dependence; Maintenance treatment; Methadone; Buprenorphine; Depot; Implant

Core Tip: Although opioid maintenance therapy with methadone or buprenorphine is the widely accepted first line treatment in opioid use disorders (OUDs) the risk of diversion and low retention rates limit its use. While previous attempts to introduce long-acting methadone analogues have failed due to cardiac side effects in recent years, three different long-acting buprenorphine formulations have been developed and successfully studied in opioid users, two weekly or monthly depot injections (CAM 2038, RBP-6000) and one implant (probuphine). The prospects of these new medications are significant by optimizing retention and compliance and minimizing the risk of diversion. Thus, these novel medications can facilitate treatment of OUDs significantly.