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Heroin Addiction and Related Clinical Problems: 2025, 27, 1

Long-Term Outcomes of Opioid Use Disorder Treatment with Extended-Release Buprenorphine Implant: One-Year Post-Removal Follow-Up

Sarah Vecchio, Sabino Cirulli, Claudio Pierlorenzi, Concettina Varango, Roberta Marenzi, Marco Riglietta, and Valentina Giacon

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2025-1

Summary: Background: Opioid Use Disorder (OUD) is a chronic condition characterised by compulsive opioid use, posing significant challenges to public health. While Opioid Agonist Therapy (OAT) remains the cornerstone of OUD management, issues such as non-adherence, misuse, and social stigma hinder its effectiveness. Extended-release buprenorphine implants offer a novel alternative to address these challenges. This study aims to evaluate the long-term outcomes of patients treated with the buprenorphine implant, focusing on the post-removal phase. Methods: This case series included nine male patients with OUD, aged 24–60 years, treated with buprenorphine implants for six months and followed up for one-year post-implant removal, with assessments at six-time points. Data were collected on withdrawal symptoms, substance use, OAT discontinuation, and quality of life (QoL). Supportive therapies, including symptomatic treatments and psychotherapy, were documented. Results: Following implant removal, withdrawal symptoms peaked in the first week but were predominantly mild and resolved by three months in most patients. Six months post-removal, seven remaining patients were free from OAT, and one took 4 mg of oral buprenorphine. Withdrawal symptoms resolved in most patients 45 days post-removal. Substance use declined significantly, with no recreational opioid use among the eight patients in six months. QoL improvements were notable, with patients reporting better social relationships, employment stability, and mood. After one year, none of the five remaining patients required OAT or reported withdrawal symptoms or substance use. Conclusions: In the post-removal phase, the buprenorphine implant facilitated a high rate of OAT discontinuation, minimal withdrawal symptoms, and sustained abstinence from opioids and other substances. Improvements in QoL persisted, with patients reporting social and professional benefits. These findings highlight the implant's potential to enable a successful transition away from OAT, supporting long-term recovery in motivated and well-prepared patients.

Keywords: Opioid use disorder; opioids; opioid agonist therapy; addiction; buprenorphine implant; long-acting opioids; extended-release buprenorphine