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The outcome they chose to measure

A trial is testing tirzepatide alongside buprenorphine in opioid use disorder. It has no results — but its primary outcome is already decided, and it is not opioid use.

Wesley Jenkins5 min read
What has been published, and what has notdesignpublishedsample: 310, randomized 1:1publishedprimary outcome: 6-month retentionpublishedresultsnot yetNothing on this site is sold for opioid use disorder.

There are no findings here, and that is the reason to read it carefully rather than to skip it. When this trial reports, its headline number will be whatever its primary outcome says, and the primary outcome has already been chosen — the decision that shapes what a trial of these drugs in addiction can conclude.

What is being tested

The trial is enrolling 310 adults with moderate to severe opioid use disorder who have recently started buprenorphine, randomized one to one to tirzepatide or placebo. [1] Participants attend weekly research visits for six months, with longer assessments at one, three and six months and a safety visit at week 30. Randomization is balanced by site and by whether the buprenorphine is transmucosal or extended-release.

Buprenorphine is the treatment. Tirzepatide is the adjunct under test. The authors describe this as the first randomized trial of tirzepatide in opioid use disorder, which is worth holding next to how much has already been claimed about what these drugs reach beyond weight.

What a design paper can tell you

Which question is being asked, how many people it is being asked of, and what would count as an answer. Those are decided before any data exist and cannot be quietly revised afterwards, which is the point of publishing them.

What it cannot tell you is anything about whether the drug works. Naming the endpoint in advance is what makes the eventual result interpretable — the opposite of an analysis whose framing is chosen after the numbers are in.

Why this appears on a price site

Because the list of things these drugs are being tested for keeps growing, and each new indication eventually becomes a marketing claim somewhere. Watching which trials are running is how you recognize a claim that has outrun its evidence.

Nothing on this roster is sold for opioid use disorder, nobody should obtain tirzepatide to treat it, and the participants in this trial are receiving it alongside proper treatment under supervision. The pattern to remember is the one from the smoking work: a drug with a real effect on one addiction endpoint may do nothing for a neighboring one, and only the trial that specified its endpoint in advance can tell them apart.

Frequently asked

Does tirzepatide help with opioid use disorder?
Nobody knows. This is a study design paper for a trial that has not reported. No results exist.
What is the trial measuring?
Whether participants are still on buprenorphine at six months. The proportion of opioid-negative urine samples is a secondary outcome.
Why is retention the primary outcome rather than opioid use?
Because staying in treatment is among the strongest predictors of survival in opioid use disorder. It also means the headline result will be about remaining in treatment, not about using less.
How large is it?
Approximately 310 adults with moderate to severe opioid use disorder, randomized one to one against placebo over six months.

Sources

  1. [1] Winhusen TJ, et al. (2026). Evaluation of Tirzepatide as an Adjunct to Buprenorphine for the treatment of opioid use disorder (TAB) trial: study design and rationale Contemporary Clinical Trials. PMID 42600923

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