ArticleJournal of the American College of Emergency Physicians open2020
Microdosing and standard-dosing take-home buprenorphine from the emergency department: A feasibility study.
Article in Journal of the American College of Emergency Physicians open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluating Microdosing in Emergency Departments: A Randomized Controlled Trial Comparing the Effectiveness of Buprenorphine/Naloxone Microdosing vs. Standard Dosing (EMED Study)
Optimizing Outcomes for Patients Presenting to Emergency Departments With Opioid Poisoning
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.Pharmacotherapy · 2022Pooled it
- Patient Perspectives on Offers of Buprenorphine in the Emergency Department.JAMA network open · 2026Article
- Opioid agonist therapy discontinuation in British Columbia: a cross-sectional study of people who access harm reduction services.BMJ open · 2025Article
- Low-dose buprenorphine initiation and treatment continuation among hospitalized patients with opioid dependence: A retrospective cohort study.Journal of substance use and addiction treatment · 2024Article
- Practices and Outcomes Associated With Sublingual Buprenorphine Use in a Critically Ill Population.Critical care explorations · 2024Article
- Healthcare provider perspectives on emergency department-initiated buprenorphine/naloxone: a qualitative study.BMC health services research · 2024Article
- Implementation of an education session on buprenorphine induction in the emergency department, a resident-led initiative.Harm reduction journal · 2024Article
- Perspectives of healthcare workers on the integration of overdose detection technologies in acute care settings.Addiction science & clinical practice · 2024Article
- Article
- Low-Dose Initiation of Buprenorphine: A Narrative Review.Current pain and headache reports · 2023Review
- Article
- Validation of Two Diagnostic Assessments for Opioid and Stimulant Use Disorder for Use by Non-Clinicians.Psychiatric research and clinical practice · 2023Article
- Reddit discussions about buprenorphine associated precipitated withdrawal in the era of fentanyl.Clinical toxicology (Philadelphia, Pa.) · 2022Article
- Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study.Frontiers in pharmacology · 2021Article
- Microdosing and standard-dosing take-home buprenorphine from the emergency department: A feasibility study.Journal of the American College of Emergency Physicians open · 2020Article
- Uptake of Low-dose Buprenorphine Initiation and Associated Patient Characteristics in British Columbia, Canada: A Population-based Cohort Study.Journal of addiction medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveEmergency department (ED)-initiated buprenorphine may prevent overdose. Microdosing is a novel approach that does not require withdrawal, which can be a barrier to standard inductions. We aimed to evaluate the feasibility of an ED-initiated buprenorphine/naloxone program providing standard-dosing and microdosing take-home packages and of randomizing patients to either intervention.
methodsWe broadly screened patients ≥18 years old for opioid use disorder at a large, urban ED. In a first phase, we provided consecutive patients with 3-day standard-dosing packages, and then we provided a subsequent group with 6-day microdosing packages. In a second phase, we randomized patients to standard dosing or microdosing. We attempted 7-day telephone follow-ups and 30-day in-person community follow-ups. The primary feasibility outcome was number of patients enrolled and accepting randomization. Secondary outcomes were numbers screened, follow-up rates, and 30-day opioid agonist therapy retention.
resultsWe screened 3954 ED patients and identified 94 with opioid use disorders. Of the patients, 26 (27.7%) declined participation: 10 identified a negative prior experience with buprenorphine/naloxone as the reason, 5 specifically cited precipitated withdrawal, and none cited randomization. We enrolled 68 patients. A total of 14 left the ED against medical advice, 8 were excluded post-enrollment, 21 received standard dosing, and 25 received microdosing. The 7-day and 30-day follow-up rates were 9/46 (19.6%) and 15/46 (32.6%), respectively. At least 5/21 (23.8%) provided standard dosing and 8/25 (32.0%) provided microdosing remained on opioid agonist therapy at 30 days.
conclusionsED-initiated take-home standard-dosing and microdosing buprenorphine/naloxone programs are feasible, and a randomized controlled trial would be acceptable to our target population.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.