ArticleJournal of general internal medicine2026
"You're Hoping for the Best, but Preparing for the Worst": Discussions of Starting Buprenorphine in the Context of Fentanyl Use with Clinicians and People Who Use Fentanyl.
Article in Journal of general internal 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.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundIllicitly manufactured fentanyl has become the most prevalent opioid in the USA and accounts for the largest percentage of overdose events. Fentanyl has also complexified starting buprenorphine, a highly effective medication for treating opioid use disorder. This qualitative study explored the experiences of clinicians and people who use fentanyl (PWUF) starting buprenorphine in the context of fentanyl use.
methodsSemi-structured interviews were conducted with clinicians and PWUF in the Seattle, WA, area. Interviewers inquired about substance use and treatment history, decision-making and sources of information related to MOUD, buprenorphine initiation logistics and experience, barriers and facilitators to starting buprenorphine, and insights and observations about treatment settings. Researchers used a rapid analysis process to analyze the data.
resultsAnalysis included 43 participants (15 clinicians, 28 PWUF). Clinicians had a mean age of 40 years, were 53.3% male, and were 93.3% White. PWUF had a mean age of 44 years, were 66.6% male, were 46.4% white, and were 32.1% Black/African American. The prominent themes were (1) Fear of withdrawal, both precipitated and otherwise, was a top concern when starting buprenorphine in the context of fentanyl; (2) In the fentanyl era, there is no longer a one-size-fits-all approach to buprenorphine initiation, leading to uncertainty among both clinicians and PWUF; (3) Starting buprenorphine was hampered by easy access to cheap fentanyl; and (4) PWUF reported successful buprenorphine starts were facilitated by their own mindset and determination.
conclusionsWhile both PWUF and clinicians identified precipitated withdrawal as a major concern when initiating buprenorphine, it was just one of many barriers. More research is needed in order to provide clinicians with accurate, up-to-date guidance on starting buprenorphine. As we aim to provide buprenorphine to more people, it will be important to engage with PWUF to identify and address real-world barriers.
Indexed as
Identifiers
41912941What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.