Dr. Ginnie Sawyer-Morris Receives an ASAM Abstract Submission Award
FRI congratulates Dr. Ginnie Sawyer-Morris on receiving the American Society of Addiction Medicine (ASAM) Abstract Submission Honorable Mention – Associated Professional at ASAM’s 57th Annual Conference in San Diego, California. She is receiving the award for her abstract, titled “An Open Label Pilot Randomized Controlled Trial (RCT) of Low- vs High-Dose Telemedicine Buprenorphine Initiation.”
In this open label pilot RCT, the team enrolled 39 adults with moderate-to-severe opioid use disorder and confirmed fentanyl use who were initiating treatment at an outpatient buprenorphine clinic in Maryland. Participants were randomized to a 7-day low-dose (0.5-16 mg) or high-dose (2-24 mg) buprenorphine initiation schedule. In the intent-to-treat sample, 71.4% of high-dose and 83.3% of low-dose participants met adherence criteria, a difference that was not statistically significant. Among study completers, adherence was 93.8% in both arms. In terms of treatment barriers, 19% of high-dose participants never initiated treatment; reasons provided included fear of precipitated withdrawal, inability to reach the withdrawal threshold, or they were lost to follow-up. Comparatively, 100% of low-dose participants initiated treatment, suggesting differential barriers to engagement. Among completers, withdrawal symptoms declined significantly over the 7-day period in both groups. However, the high-dose group experienced faster early symptom relief as indicated by significant dayXarm interactions on days 2-4. This trend was further supported by adjunctive medication use patterns: in the high-dose arm, medication use declined from an average of 6.1 to 3.3 medications per day, while in the low-dose arm adjunctive medication use remained relatively stable at around 5.3 to 5.6 per day. Precipitated withdrawal occurred in approximately 18% of participants across both arms, but all cases were mild to moderate with zero severe events recorded. These pilot findings provide important preliminary evidence that both strategies are feasible via telemedicine and suggest that individualized approaches, considering patient readiness, tolerance for withdrawal risk, and engagement barriers, may optimize outcomes. These pilot estimates lay critical groundwork for larger, adequately powered trials to establish best-practice buprenorphine initiation strategies in the fentanyl era.
More information about the awardees can be found at: https://annualconference.asam.org/fsPopup.asp?efp=UUdYWkdSQVIyNjg4MA&PosterID=776783&rnd=0.7607236&mode=posterInfo.