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LAI Buprenorphine Advantage — MRCPsych Paper B MCQ

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ModerateSubstance MisuseLAI Buprenorphine AdvantageMRCPsych Paper B

A 40-year-old man with opioid dependence is stable on daily sublingual buprenorphine. During shared decision-making, he asks about switching to prolonged-release subcutaneous buprenorphine (Buvidal). Which statement describes the clearest practical advantage of this formulation?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — It replaces daily dosing with healthcare-professional administration weekly or monthly

Buvidal is administered subcutaneously by a healthcare professional at weekly or monthly intervals. It can therefore remove the need for daily sublingual dosing, dispensing or supervised consumption, reducing treatment burden and opportunities for diversion. It cannot be supplied for take-home self-administration, so A is incorrect. NICE notes that its medicine acquisition cost may be higher than that of other opioid-substitution treatments, excluding C. Evidence does not establish a lower overall adverse-effect burden; injection-site reactions are an additional consideration, excluding D. It does not offer a clinically relevant faster onset, and the weekly formulation reaches peak plasma concentration at approximately 24 hours, excluding E. Treatment should remain embedded within medical, psychological and social care.

Reference: NICE. Opioid dependence: buprenorphine prolonged-release injection (Buvidal), ES19, Factors for decision making. 2019. https://www.nice.org.uk/advice/es19/chapter/Factors-for-decision-making