A monthly injection for opioid dependence is being hailed as a “game changer”. And new evaluation suggests it might justify the hype.
Researchers involving the University of Hertfordshire have found that patients treated with Buvidal, a long-acting buprenorphine injection, made fewer demands on NHS services than those prescribed methadone or oral alternatives.
However, the most striking difference was ambulance callouts.
Yet the message from the report is measured rather than evangelical. Buvidal works – but it works best when it is not asked to work alone.
A treatment that frees up time – and services
Opioid dependency remains one of the UK’s most persistent public health challenges. Globally, around 60 million people were using unregulated opioids in 2023. In England, nearly 330,000 adults were in contact with drug and alcohol services last year, many for opioid-related treatment.
For decades, the backbone of care has been substitution therapy: methadone or oral buprenorphine, typically collected daily under supervision. Effective, but rigid. For some, life-defining.
Buvidal changes the rhythm. Instead of daily pharmacy visits, patients receive a weekly or monthly injection – a way to avoid structuring every morning around medication.
Rolled out widely during the Covid pandemic when face-to-face services were restricted, the drug has since been described as transformative for some patients.
Professor Fabrizio Schifano, Professor of Clinical Pharmacology at the University of Hertfordshire, said the system-level impact is measurable:
“Our study identified that patients on Buvidal tended to use healthcare services less often than those on methadone and oral buprenorphine, which translates into lower healthcare utilisation costs to the NHS.
“Indeed, the difference was most marked in relation to use of the ambulance service.”
Lower healthcare demand is not just a clinical win – it’s an economic one.
Stability – with caveats
Commissioned by the Welsh Government and led by the University of South Wales, the report looked beyond headline claims to examine how Buvidal is functioning in practice.
Professor Katy Holloway said what emerged was a nuanced picture:
“This research has enabled us to develop an in-depth understanding of the evolution of Buvidal treatment in Wales.
“What comes through very strongly is that Buvidal can offer people a sense of stability and breathing space that daily treatments don’t always allow.
“For some, it reduces the constant pressure of managing withdrawal and appointments, making it easier to focus on work, relationships, and recovery. But it’s not a silver bullet. The context around the substance use really matters.”
For many, the injection creates room to rebuild routine and relationships. Retention rates are strong. Illicit opioid use often declines.
But addiction rarely exists in a vacuum.
Some participants struggled during induction onto Buvidal. Others continued to use additional substances to manage boredom, isolation or resurfacing trauma. Staff training and clinical confidence proved decisive in shaping outcomes.
No silver bullets in public health
The report’s central argument is not about chemistry but context.
Buvidal, the authors say, should be embedded within a wider, person-centred system: psychological support, meaningful activity, peer networks. Not a standalone intervention but part of wraparound care.
Prof Holloway put it plainly:
“This evaluation reminds us that effective treatment isn’t just about medication. It’s about dignity, giving people real options, and addressing the root cause of substance use.
“While Buvidal can play an important role, it must be embedded in compassionate, well-resourced, wrapround care, and patient networks and forums.”
The findings land at a critical moment. Opioid-related harms continue to strain communities and services across the UK. Innovation is welcome. But sustainability matters more.
The evaluation – a collaboration between the University of Hertfordshire, the University of South Wales and Wrexham University – suggests Buvidal may indeed ease NHS pressure.
