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Home > High-dose buprenorphine induction in the emergency department for treatment of opioid use disorder.

Herring, Andrew A and Vosooghi, Aidan A and Luftig, Joshua and Anderson, Erik S and Zhao, Xiwen and Dziura, James and Hawk, Kathryn F and McCormack, Ryan P and Saxon, Andrew and D'Onofrio, Gail (2021) High-dose buprenorphine induction in the emergency department for treatment of opioid use disorder. JAMA Network Open, 4, (7), e2117128. 10.1001/jamanetworkopen.2021.17128.

External website: https://jamanetwork.com/journals/jamanetworkopen/f...

Question: Is high-dose (>12 mg) buprenorphine induction safe and well tolerated in patients with untreated opioid use disorder who present to the emergency department?

Findings: In this case series of 579 cases, 54 clinicians followed a high-dose buprenorphine (monoproduct) protocol. There were no documented episodes of respiratory depression or excessive sedation, and precipitated withdrawal was rare (0.8% of cases) and was not associated with dosing.

Meaning: These findings suggest that high-dose buprenorphine induction, adopted by multiple clinicians in a single-site, urban emergency department, was safe and well tolerated in patients with untreated opioid use disorder.


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