Management of treatment-refractory opioid use disorder: a case-series of a modified maintenance protocol

This case series presents a novel treatment combining buprenorphine extended-release injection with hydromorphone or slow release oral morphine for individuals with OUD who have not responded to standard opioid agonist treatment. The approach showed promise in managing withdrawal and cravings, potentially improving treatment retention. Further research is needed to evaluate long-term outcomes and optimize retention strategies to reduce opioid-related mortality.