{"doi":"10.1111/acem.70191","title":"Drug Use After Emergency Department‐Initiated Injectable Buprenorphine: A Secondary Analysis of the <scp>ED</scp> ‐ <scp>INNOVATION</scp> Ancillary Safety and Feasibility Trial","abstract":"STUDY OBJECTIVE: To characterize opioid and nonopioid drug use in the week following emergency department (ED)-initiated extended-release buprenorphine (XR-BUP) treatment using both self-reported data and urine drug screens (UDS). METHODS: This study uses data collected during a nonrandomized clinical trial of patients with untreated opioid use disorder (OUD), testing the safety and feasibility of initiating XR-BUP in patients presenting with minimal to mild withdrawal. The study was conducted from July 2020 to May 2023 across four urban academic EDs in the Northeast, Mid-Atlantic, and Pacific regions of the United States. A total of 100 participants, 18 years or older with OUD defined by DSM-5 criteria, a clinical opiate withdrawal scale (COWS < 8), and a positive opioid urine screen were included. Individuals with recent MOUD treatment, presentation for overdose, or concurrent methadone use were excluded. All participants received a single subcutaneous injection of 24 mg XR-BUP (CAM2038) during their ED visit. The primary outcomes were self-reported daily opioid and nonopioid drug use over 7 days postinjection using daily Qualtrics surveys and UDS results on day 7. RESULTS: Among participants who received XR-BUP and completed daily surveys, 98% reported at least one opioid-free day, and 63% reported no opioid use across all 7 days. Day 7 UDS results showed decreased detection of opioids, stimulants, and benzodiazepines. Reported polysubstance use also declined over the observation period. CONCLUSIONS: ED-initiated XR-BUP was associated with substantial reductions in opioid and polysubstance use during the first week post-discharge, supporting its role in early overdose risk mitigation and highlighting its value as an ED-based intervention for opioid use disorder. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03658642.","journal":"Academic Emergency Medicine","year":2025,"id":583013,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9226,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03658642"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":31024,"name":"Gail D’Onofrio","orcid":"0000-0002-3833-1871","position":1,"is_corresponding":false},{"id":570754,"name":"Jeanmarie Perrone","orcid":"0000-0002-3396-6333","position":2,"is_corresponding":false},{"id":746323,"name":"Erik S. Anderson","orcid":"0000-0001-7759-4327","position":3,"is_corresponding":false},{"id":230349,"name":"James Dziura","orcid":"0000-0001-8953-6183","position":4,"is_corresponding":false},{"id":249719,"name":"Kathryn Hawk","orcid":"0000-0001-7435-5945","position":5,"is_corresponding":false},{"id":677351,"name":"Andrew A. Herring","orcid":null,"position":6,"is_corresponding":false},{"id":591966,"name":"Ryan McCormack","orcid":"0000-0002-7210-4736","position":7,"is_corresponding":false},{"id":355740,"name":"Manali Phadke","orcid":"0000-0003-2268-5963","position":8,"is_corresponding":false},{"id":237713,"name":"Elizabeth A. Samuels","orcid":"0000-0003-2414-110X","position":9,"is_corresponding":false},{"id":249729,"name":"David A. Fiellin","orcid":"0000-0002-4006-010X","position":10,"is_corresponding":false},{"id":249722,"name":"Ethan Cowan","orcid":"0000-0002-7276-0549","position":0,"is_corresponding":true}],"reference_count":28,"raw_metadata":null,"created_at":"2026-07-19T02:58:59.653747Z","pmid":"41287157","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}