In recent years, treatment options for opioid use disorder have expanded significantly with the availability of a wide range of medication formulations. Extended-release buprenorphine is a long-acting, injectable medication used to treat moderate-to-severe opioid use disorder by providing a steady, continuous dose of buprenorphine over several weeks. Needle-related anxiety and injection-site pain are frequent adverse events that can significantly impede patient adherence to extended-release buprenorphine therapy. Topical and injectable anesthetics can enhance patient comfort and support greater adherence to the treatment protocol. This report presents two cases detailing a protocol to minimize pain from extended-release buprenorphine injections. This protocol utilizes a combination of topical anesthetic skin refrigerant (vapocoolant spray), local anesthetic, and an alkalizing agent, using specific techniques to minimize discomfort. After achieving adequate local anesthesia, extended-release buprenorphine therapy was well-tolerated, with participants reporting an essentially painless procedure. Topical and injectable anesthetics can improve patient comfort during extended buprenorphine administration, boosting adherence to opioid maintenance therapy.
Sina Radparvar (Sat,) studied this question.