Symptom-Inhibited Naloxone Induction (SINI) for Buprenorphine Initiation: A Feasibility Trial

Inclusion Criteria: To be eligible for this study, participants must fulfill all the following inclusion criteria: * 19 years of age or older. * Opioid use disorder as confirmed by DSM 5 diagnostic criteria. * Clinical indication to start OAT with buprenorphine. * Willingness to tolerate mild opioid withdrawal precipitated by naloxone, expected to last less than 20 minutes. * Willing and able to have and maintain IV access for the duration of the SINI * If of childbearing potential and elected BUP-XR, agree to use an effective method of birth control. o Highly effective methods of birth control include hormonal contraceptives (e.g., combined oral contraceptives, patch, vaginal ring, injectables, and implants); intrauterine device (IUD) or intrauterine system (IUS); vasectomy and tubal ligation. Effective methods include barrier methods of contraception (e.g., male condom, female condom, cervical cap, diaphragm, contraceptive sponge). * Willing and able to provide written informed consent for study participation. Exclusion Criteria: If participants meet any of the following exclusion criteria, they will be excluded from participation in the study: * Diagnosis of severe medical or psychiatric conditions contraindicated for naloxone or buprenorphine. * Concomitant use of medications with drug-drug interactions with buprenorphine, unless alternative treatment options are less appropriate and a risk-benefit assessment has been discussed and recommended by the participant's…