Can Extended-release Injectable Medications Help Curb United States and Canada's Opioid Overdose Epidemic?

Settings throughout the United States and Canada continue to face escalating overdose epidemics. Notably, history of overdose is associated with increased risk of fatal overdose. Unfortunately, despite frequent contact with health services and the well-known mortality benefits of medications for opioid use disorder (MOUD), only a fraction of overdose survivors is successfully linked to addiction care after leaving the emergency department. This may be partially explained by well-documented challenges of oral MOUD, including the need for frequent visits to the pharmacy to receive their medications, which may limit the flexibility to acquire or sustain employment, and therefore contribute to high rates of opioid addiction care discontinuation. This commentary discusses the potential fit of different extended-release injectable MOUD to circumvent limitations of oral formulations, and thereby improve linkage and retention in care of high-risk populations, such as opioid-overdose survivors.