Optimizing Opioid Use Disorder Treatment: When Does 300 mg Outperform 100 mg of Extended-Release Buprenorphine?

Optimizing Opioid Use Disorder Treatment: When Does 300 mg Outperform 100 mg of Extended-Release Buprenorphine?

This randomized clinical trial compares 100-mg and 300-mg maintenance doses of extended-release buprenorphine. While overall efficacy was similar, the 300-mg dose significantly improved abstinence among patients with high-frequency fentanyl use, suggesting a need for dose-intensification in the era of potent synthetic opioids.
Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches

Physiologic PK-PD Modeling Reveals Greater Fentanyl Potency for Ventilatory Depression Than Simpler Approaches

A population PK–PD study in healthy volunteers found that a physiologic model incorporating CO2 kinetics and a ventilatory controller estimates fentanyl potency for ventilatory depression at ~2.3 ng/mL—substantially lower than estimates from simpler models, with implications for perioperative opioid safety and modeling methodology.