SynthesisPharmacotherapy2022
Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.
Synthesis in Pharmacotherapy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Evidence-based consensus guidelines for the pharmacological management of substance dependence: Recommendations from the British Association for Psychopharmacology.Journal of psychopharmacology (Oxford, England) · 2026Guideline
- Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: an updated systematic review.Addiction science & clinical practice · 2025Pooled it
- Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.Pharmacotherapy · 2022Pooled it
- Mental Health Distress Is Associated With Higher Pain Interference in Patients With Opioid Use Disorder Stabilized on Buprenorphine or Methadone.Substance use & addiction journal · 2024Trial
- Incidence of Precipitated Withdrawal During a Multisite Emergency Department-Initiated Buprenorphine Clinical Trial in the Era of Fentanyl.JAMA network open · 2023Trial
- Retention in Telehealth-Delivered Buprenorphine Treatment for Opioid Use Disorder: Multistate Retrospective Cohort Study.Journal of medical Internet research · 2026Article
- Buprenorphine Products for the Treatment of Pain: Relative Risk of Abuse and Related Clinical Outcomes Compared to Full μ-Opioid Agonist Medications.Pain and therapy · 2026Article
- Infant caregiving, relational factors, mood, and pain in perinatal opioid use disorder: A prospective cohort with ecological momentary assessment.Addictive behaviors · 2026Article
- Buprenorphine for Children and Adolescents with Sickle Cell Disease: A Scoping Review.Children (Basel, Switzerland) · 2026Review
- Optimizing Opioid Use in Pain Management: A Comprehensive Review of Clinical Benefits, Risks, and Dependence.Healthcare (Basel, Switzerland) · 2026Review
- Clinical perspectives: navigating buprenorphine formulations for pain treatment and opioid use disorder-a case-based approach.Pain medicine (Malden, Mass.) · 2026Article
- Patient perspectives on buprenorphine/naloxone for chronic noncancer pain: A qualitative interview study.Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- High-dose buprenorphine inductions in hospital settings.American journal of medicine open · 2025Article
- Novel oral LAAM immediate-release capsules for treating opioid use disorder.International journal of pharmaceutics · 2025Article
- Clinical strategies for low-dose overlap initiation of buprenorphine and potential barriers to use.The mental health clinician · 2025Article
- Use of Buprenorphine in Managing Cancer Pain and Transition to Survivorship.Clinical journal of oncology nursing · 2025Article
- Buprenorphine Pharmacodynamics: A Bridge to Understanding Buprenorphine Clinical Benefits.Drugs · 2025Review
- The intersection of aging, pain, and opioid use disorder: a retrospective chart review from an outpatient opioid treatment clinic.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Age and racial and ethnic disparities in filled buprenorphine prescriptions post-emergency department visit in Nevada.Journal of the American College of Emergency Physicians open · 2024Article
- Emergency department management of opioid use disorder in pediatric patients.Journal of the American College of Emergency Physicians open · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Buprenorphine possesses many unique attributes that make it a practical agent for adults and adolescents with opioid use disorder (OUD) and/or acute or chronic pain. Sublingual buprenorphine has been the standard of care for treating OUD, but its use in pain management is not as clearly defined. Current practice guidelines recommend a period of mild-to-moderate withdrawal from opioids before transitioning to buprenorphine due to its ability to displace full agonists from the μ-opioid receptor. However, this strategy can lead to negative physical and psychological outcomes for patients. Novel initiation strategies suggest that concomitant administration of small doses of buprenorphine with opioids can avoid the unwanted withdrawal associated with buprenorphine initiation. We aim to systematically review the buprenorphine initiation strategies that have emerged in the last decade. Embase, PubMed, and Cochrane Databases were searched for relevant literature. Studies were included if they were published in the English language and described the transition to buprenorphine from opioids. Data were collected from each study and synthesized using descriptive statistics. This review included 7 observational studies, 1 feasibility study, and 39 case reports/series which included 924 patients. The strategies utilized between the literature included traditional initiation (47.9%), microdosing with various buprenorphine formulations (16%), and miscellaneous methods (36.1%). Traditional initiation and microdosing initiation were compared in the data synthesis and analysis; miscellaneous methods were omitted given the high variability between methods. Overall, 95.6% of patients in the traditional initiation group and 96% of patients in the microdosing group successfully rotated to sublingual buprenorphine. Initiation regimens can vary widely depending on patient-specific factors and buprenorphine formulation. A variety of buprenorphine transition strategies are published in the literature, many of which were effective for patients with OUD, pain, or both.
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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.