High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder

Source:

Herring AA, Vosooghi AA, Luftig J, et al. High-Dose Buprenorphine Induction in the Emergency Department for Treatment of Opioid Use Disorder. JAMA Netw Open. 2021;4(7):e2117128. doi:10.1001/jamanetworkopen.2021.17128

Key Points

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.