ArticleJournal of addiction medicine2026
Self-Reported History of Precipitated Withdrawal: A Cross-Sectional Study of People Who Use Unregulated Opioids.
Article in Journal of addiction medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
9 authors.
Funding
Abstract
objectivesIn contrast to methadone, buprenorphine is susceptible to precipitated withdrawal complicated by fentanyl in the unregulated opioid supply. The objective of this study was to examine associations between drug supply characteristics and the prevalence of precipitated withdrawal.
methodsWe conducted a cross-sectional analysis of a cohort study during 2023-2025 among people with a lifetime history of buprenorphine or methadone treatment currently using a drug checking program. Explanatory variables included drug supply, health care, and treatment characteristics. The primary outcome was a self-reported lifetime history of precipitated withdrawal during a buprenorphine induction. Binomial linear regression models were used to calculate prevalence ratios with 95% CIs.
resultsAmong 234 people, 64% were men, 67% were non-Hispanic white, 41 was the median age, 94% reported a history of fentanyl use, 92% had a history of methadone treatment, and 68% had a history of buprenorphine treatment. Among those with a history of buprenorphine treatment, 29% reported precipitated withdrawal during buprenorphine inductions, of which 67% occurred when starting via outpatient pathways. Buprenorphine-associated precipitated withdrawal was slightly higher among those with recent xylazine use compared with those without (32% vs 22%, prevalence ratio: 2.10, 95% CI: 0.94, 4.67). People with recent buprenorphine inductions commonly started without clinical or social support (63%) or used standard dosing (53%).
conclusionsBuprenorphine-associated precipitated withdrawal was commonly reported. Improved guidance and treatment approaches should be prioritized to minimize these complications, particularly in outpatient settings.
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