ArticleJournal of addiction medicine2025
A Novel Intravenous Buprenorphine Micro-Infusion Strategy: Application in Critical Care and Opioid Use Disorder.
Article in Journal of addiction medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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Authors and funding
10 authors.
Funding
Abstract
objectivesBuprenorphine (BUP), a partial mu-opioid receptor (MOR) agonist, is an effective analgesic and is standard-of-care for treating opioid use disorder (OUD). Transitioning from full MOR agonists to stable BUP dosing can be challenging as some patients experience BUP-precipitated opioid withdrawal (BPOW) due to its ability to displace full MOR agonists. To improve patient tolerability low-dose BUP initiation protocols deliver small, progressively escalating BUP doses, allowing gradual displacement of other opioids and replacement with BUP. We describe a case series using a novel intravenous BUP "micro-infusion" protocol for rapid medication transition with no patients meeting the operational criteria for BPOW.
methodsA retrospective case series of patients who received an 8-hour 1200 mcg BUP infusion (150 mcg/hr) and one (or more) sublingual BUP doses after medical or nonmedical full MOR agonist administration. Variables included demographic characteristics, presence of OUD, opioid medications, BUP continuation/prescription fill rates, and evidence of BPOW based on Clinical Opiate Withdrawal Scale (COWS) scores.
resultsOf 23 patients included, 8 presented with current OUD (34.8%) and 15 were treated with full MOR agonists for analgesia (65.2%) before BUP micro-infusion. There were no instances of BPOW. Among the 8 patients with OUD, 5 (62.5%) continued sublingual BUP and filled their prescription for BUP upon discharge.
conclusionsOverall, the 8-hour intravenous 1200 mcg BUP micro-infusion protocol was well-tolerated with no clinically apparent cases of BPOW and similar rates of continued sublingual BUP treatment post-discharge among patients with OUD compared with other low-dose BUP initiation protocols.
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