Short Abstract

Mixed-methods evaluation of long-acting injectable buprenorphine in rural Cornwall shows reduced opioid use, improved quality of life, and strong user endorsement. Findings advance equity-focused evaluation in underserved settings.

Description

This mixed-methods evaluation explores the implementation and impact of long-acting injectable buprenorphine (LAIB) within a rural and coastal opioid substitution treatment (OST) service in Cornwall, UK. Combining a retrospective cohort study (n=538) using routinely collected Treatment Outcome Profile (TOP) data with qualitative interviews (n=12) from service users, the research offers a novel, real-world assessment of LAIB’s effectiveness and acceptability in a context of reduced relative access.

Quantitative analysis demonstrated that LAIB was associated with significantly reduced opioid use (p<0.001) and improved quality of life (p=0.001) compared to methadone, though no significant differences were found in employment outcomes or non-opioid drug use. Qualitative findings identified five key themes: improved relationships, enhanced wellbeing, increased independence, positive recovery narratives, and future planning. Participants described LAIB as transformative, citing reduced cravings, greater autonomy, and improved functioning. Monthly dosing was seen as a major benefit, reducing exposure to opioid-using networks and supporting relationships with family.

This evaluation contributes to the field by demonstrating how mixed-methods approaches can generate actionable insights into service innovation, particularly in underserved rural settings. It advances evaluative practice by integrating lived experience with routine data, highlighting the psychosocial dimensions of pharmacological interventions. The findings support LAIB as a promising treatment option in geographically isolated communities and underscore the need for integrated support services to address persistent inequalities.

By highlighting community voices and contextual realities, this study aligns with the conference’s commitment to equity, learning, and the use of evaluation to improve lives.