(37) Advancing Access to Long-Acting Injectable Buprenorphine Through Community Pharmacies

Background & Introduction: Despite the effectiveness of medications for opioid use disorder (MOUD), only 25.1% of adults with OUD received treatment in 2022, underscoring a treatment gap driven by access barriers, stigma, and geographic inequities.1,2 Long-acting injectable buprenorphine (LAIB) offers sustained coverage and may improve adherence by reducing dosing burden. However, real-world implementation has been limited, particularly in traditional clinic-based or “white bagging” models, which introduces logistical challenges related to storage, coordination, and billing. 2,3

Community pharmacies represent a scalable and underutilized access point, offering extended hours and geographically distributed locations that can reduce delays and normalize MOUD delivery. These advantages are particularly relevant in rural areas, where MOUD availability and prescriber density remain limited. 3,4

Of the 27 states that permit community pharmacists to administer LAIB, 5 Albertsons Companies have implemented this service in 24 states, with continued expansion planned. Within Albertsons Companies pharmacies, LAIB prescriptions are managed through coordinated workflow that minimizes delays between prescribing and administration. Medication is shipped to the administering pharmacy, stored appropriately, and administered on-site, supporting timely treatment and continuity of care.

The primary objective is to characterize LAIB utilization in a grocery chain community pharmacy setting, with a secondary objective of assessing geographic and prescribing patterns.

Methods: This study is a retrospective, descriptive analysis of LAIB administrations delivered through Albertsons Companies pharmacy locations in the United States. The study was designed to characterize real-world utilization of pharmacy-based LAIB administration services and to examine geographic patterns of care delivery across participating states.

Inclusion criteria include adult patients (≥18 years of age) who were prescribed and received at least one LAIB administration through an Albertsons Companies pharmacy during the study period from August 1st, 2024, through December 31st, 2025. All eligible LAIB administrations documented within the pharmacy dispensing systems were included. No sampling, randomization, or comparison groups were applied.
Data was extracted from internal pharmacy records and included aggregate counts of LAIB administrations by location. No patient-identifiable information was collected or analyzed.

Analyses were descriptive. LAIB utilization was summarized using counts and frequencies.

Results: A total of 6,605 LAIB doses were administered throughout the study period. Descriptive analyses demonstrate a sustained and progressive increase in LAIB administrations . Monthly administrations rose from 238 in August 2024 to 318 in December 2024, reflecting early uptake following service implementation. This upward trajectory continued throughout 2025, reaching 632 administrations in December 2025, the highest monthly volume observed during the study period. This represents a nearly threefold increase. Although minor month-to-month fluctuations were noted, the overall pattern indicates consistent growth in pharmacy-based LAIB administration over time, suggesting increasing adoption and integration of this service within grocery-chain community pharmacy practice.

Geographic analysis shows that Albertsons Companies pharmacies administered LAIB directly to patients with OUD in 19 states during the study period.

Administration volumes were concentrated in the Western United States, with Montana accounting for the highest number of administrations (1,775), followed by California (1,285) and Washington (760). Additional administrations were observed across the Midwest, South, and Northeast, indicating broader geographic reach and access.

Further analysis identified the top areas of administration. High-volume activity clustered in specific communities, with Lafayette, Louisiana recording the highest number of administrations (714), followed by Billings, Montana (697), and Butte, Montana (664). These findings highlight both regional and site-specific patterns of LAIB uptake.

Analysis of prescribing patterns reveal that a small number of individual prescribers are responsible for a substantial proportion of LAIB administrations at specific locations, suggesting the influence of local clinical champions and possibly telehealth-enabled prescribing models. In Butte, Montana, a single prescriber accounted for 429 LAIB prescriptions while another prescriber contributed 206. Similarly, high-volume individual provider prescribing was observed in Hermiston, Oregon (276), Carencro, Louisiana (243), and Pomona, California (170).

Collectively, these findings align with the study objectives by demonstrating increasing utilization of LAIB within a community pharmacy setting and highlighting geographic patterns of administration that may inform future expansion and access strategies.

Conclusion & Discussion: The upward trend and broad geographic reach highlight the growing adoption and integration of LAIB services in a grocery-chain pharmacy setting. Notably, high volumes in states such as Montana and rural areas like Billings and Butte underscore the important role of community pharmacies in expanding access to OUD treatment in underserved regions. These findings suggest that community pharmacies can address treatment gaps such as scheduling, transportation, and stigma, particularly in areas with limited healthcare infrastructure. By expanding access points, pharmacies can connect more patients to evidence-based OUD treatment.

Concentration of prescribing activity in rural regions may reflect the presence of local champions and telehealth providers who are leveraging pharmacy-based administration to reach patients who might otherwise lack access to evidence-based OUD care. Pharmacies offer a unique solution by providing a physical location for telehealth prescribers to connect patients with LAIB. This highlights the importance of provider engagement and collaboration in expanding the reach of LAIB.

Limitations include the observational nature of the analysis, potential variability in pharmacy-level implementation, and lack of patient-level outcome data. Nonetheless, the results provide strong evidence for impact of pharmacy-based LAIB administration, informing future strategies to expand access to OUD treatment.

References: 1. Martin E, Maher H, McKeon G, Patterson S, Blake J, Chen KY. Long-acting injectable buprenorphine for opioid use disorder: A systematic review of impact of use on social determinants of health. J Subst Abuse Treat. 2022;139:108776. doi:10.1016/j.jsat.2022.108776
2. Dowell D, Brown S, Gyawali S, Hoenig J, Ko J, Mikosz C, Ussery E, Baldwin G, Jones CM, Olsen Y, Tomoyasu N, Han B, Compton WM, Volkow ND. Treatment for opioid use disorder: population estimates — United States, 2022. MMWR Morb Mortal Wkly Rep. 2024;73(25):567-574. doi:10.15585/mmwr.mm7325a1
3. Haight BR, Learned SM, Laffont CM, et al. Efficacy and safety of a monthly buprenorphine depot injection for opioid use disorder: a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2019;393(10173):778-790. doi:10.1016/S0140-6736(18)32259-1. PMID: 30792007.
4. Nguyen T, Andraka-Christou B, Simon K, Bradford WD. Comparison of Rural vs Urban Direct-to-Physician Commercial Promotion of Medications for Treating Opioid Use Disorder. JAMA Netw Open. 2019;2(12):e1916520. Published 2019 Dec 2. doi:10.1001/jamanetworkopen.2019.16520
5. Bratberg J, Martin S, Ryan E, Siegel Z, Caetano M. State laws permitting expanded access to long-acting buprenorphine formulations in community pharmacies. Presented at: Innovations in Pharmacy Training and Practice to Advance Patient Care: A Workshop; May 29, 2025; Washington, DC. Accessed January 22, 2026. https://www.ncpa.co/pdf/2025/poster/State-Laws-Permitting-Expanded-Access-to-Long-Acting-Buprenorphine.pdf