The opioid epidemic continues to devastate communities across the United States, claiming more than 100,000 lives annually. In the fight against this crisis, medications for opioid use disorder (MOUDs), such as injectable buprenorphine treatment, have proven to be life-saving tools. These medications reduce cravings, ease withdrawal symptoms, and help individuals regain stability in their lives.
Among MOUDs, long-acting injectable formulations are especially promising — providing sustained medication coverage, improved adherence, and reduced diversion risk. But despite these benefits, access remains alarmingly limited. A new study published in JAMA reveals that only about one-third of substance use treatment facilities currently offer injectable buprenorphine treatment. This access gap reflects major systemic barriers that urgently need to be addressed.
What Is Injectable Buprenorphine Treatment?
Injectable buprenorphine treatment refers to long-acting formulations of buprenorphine, a partial opioid agonist used to manage opioid use disorder (OUD). The injectable form is designed to release the medication over an extended period — weekly or monthly — helping patients avoid daily dosing and stay on track with their recovery.
The first monthly injectable buprenorphine product, Sublocade, was approved by the FDA in 2017. Patients must first stabilize on a short-acting buprenorphine (usually oral or sublingual) for at least seven days before transitioning to the injectable format. Once administered, the medication steadily reduces cravings and withdrawal symptoms, giving patients more consistency and control over their recovery journey.
Key Benefits of Injectable Buprenorphine Treatment
- Improved adherence: The once-weekly or monthly administration removes the burden of daily medication management, which can be especially challenging for patients facing housing instability or other life disruptions.
- Reduced diversion: Because the medication is administered by a healthcare provider, there’s minimal risk of misuse or resale, addressing a major concern among prescribers and regulators.
- Greater convenience and privacy: Patients often prefer injections over taking pills or films every day, particularly when they’re concerned about stigma or lifestyle disruption.
- Consistency in care: Steady medication levels in the bloodstream reduce the risk of relapse due to missed doses or fluctuating adherence.
Despite these advantages, injectable buprenorphine treatment is offered at less than one-third of facilities surveyed in the JAMA study — a troubling statistic in the midst of a national overdose crisis.
Study Insights: A Glaring Access Gap
The study analyzed data from the National Substance Use and Mental Health Services Survey between 2021 and 2022 to evaluate the availability of MOUDs. The results were telling:
- 61.9% of treatment facilities offered at least one form of MOUD
- Only 32.6% offered injectable buprenorphine treatment
This stark gap suggests that while the medical community increasingly supports MOUDs, barriers remain specifically around long-acting injectable formulations.
What’s Standing in the Way?
The study identified several barriers that prevent more widespread adoption of injectable buprenorphine treatment.
Inventory and administration limitations
Injectable buprenorphine must be administered within 14 days of receipt, requiring tight inventory control. Many facilities may lack the infrastructure to handle these logistics, especially smaller or rural providers.
FDA registration requirements
Providers must register with the FDA to offer Sublocade or similar medications, adding an administrative burden that some facilities may not be equipped to manage.
Insurance hurdles
More than one-third of Medicaid formularies require prior authorization for injectable buprenorphine — a far higher rate than for oral buprenorphine, which typically does not require pre-approval. These added steps can delay care and discourage providers from offering the treatment altogether.
The Overlap with Mental Health Services
Interestingly, facilities that already offer long-acting injectable antipsychotics — such as those used to treat schizophrenia or bipolar disorder — are more likely to also offer injectable buprenorphine treatment. This suggests that infrastructure, training, and staff workflows already in place for injectable psychiatric medications can be leveraged to support SUD treatment as well.
These long-acting antipsychotic medications have been shown to improve adherence and reduce side effects, and their successful use may serve as a model for integrating MOUDs more broadly.
New Frontiers: Digital and Retail Solutions
As traditional brick-and-mortar facilities work to overcome these barriers, some innovators are creating alternative paths to access. Digital SUD treatment provider Bicycle Health recently partnered with retail pharmacy giant Albertsons to make injectable buprenorphine treatment available in more than 700 pharmacies nationwide.
“Many patients prefer injections over taking pills orally every day,” said Ankit Gupta, CEO and founder of Bicycle Health. “People with opioid use disorder now have another effective option that may be more appropriate and convenient for their long-term recovery.”
By expanding access through retail pharmacies and telehealth models, organizations like Bicycle Health are helping to close the treatment gap — especially in areas where traditional facilities may be unable to stock or administer injectable medications.
What Needs to Change?
The authors of the JAMA study call for a multifaceted strategy to increase access to injectable buprenorphine treatment:
- Streamline FDA registration requirements to make it easier for facilities to offer long-acting injectables
- Eliminate prior authorization requirements for Medicaid and other insurance plans to reduce delays in care
- Expand access through primary care providers, now that the X-waiver to prescribe buprenorphine has been eliminated
- Invest in training and infrastructure to help more facilities support injectable medications
If these steps are taken, thousands more individuals struggling with opioid use disorder could benefit from safer, more effective treatment.
The Path Forward
The opioid crisis won’t be solved by any single intervention — but injectable buprenorphine treatment is a proven tool that deserves wider adoption. With its ability to increase adherence, reduce misuse, and offer more freedom to patients, it represents a critical component of a modern, evidence-based recovery system.
Too many facilities still lack the capacity to provide this medication, and too many patients are forced to settle for less effective or less convenient options. If policymakers, providers, and payers work together to eliminate barriers and scale access, we can give more people a real chance at long-term recovery.
Are you or someone you love seeking treatment for opioid use disorder? Ask your provider about injectable buprenorphine treatment and whether it could be the right option for your recovery journey. Everyone deserves access to comprehensive, effective, and individualized care — and this breakthrough treatment could be a vital step toward lasting wellness.
