SHM Converge Scientific Abstract ePoster Gallery-Buprenorphine Microdosing for Inpatient Treatment of Opioid Use Disorder

Pdf Summary

This poster describes inpatient buprenorphine microdosing as a strategy for treating opioid use disorder (OUD) in hospitalized patients who still need full opioid agonists for pain control. Standard buprenorphine induction is usually started 12–24 hours after stopping opioids to avoid precipitated withdrawal, but this can be difficult when patients require ongoing analgesia. Microdosing offers a lower-risk alternative by gradually introducing buprenorphine while continuing other opioids, then tapering the full agonist.<br /><br />The case involves a 34-year-old man found down after a heroin overdose. He was treated in the emergency department for rhabdomyolysis and later developed right leg compartment syndrome requiring emergent fasciotomy and hydromorphone for pain. During hospitalization, he expressed interest in OUD treatment and was started on a microdosing buprenorphine-naloxone protocol alongside a hydromorphone taper. The regimen increased buprenorphine doses over several days, with dosing frequency adjusted to maximize pain relief. Hydromorphone was reduced stepwise and discontinued by day 7, after which buprenorphine was continued twice daily.<br /><br />He experienced minimal withdrawal symptoms and was discharged with a buprenorphine-naloxone prescription and close addiction follow-up. The poster concludes that inpatient buprenorphine microdosing is a promising approach for hospitalized patients with OUD who also need opioid analgesia, with reported low risk of precipitated withdrawal and successful transition to maintenance treatment.

Asset Subtitle

Leah Soderberg

Meta Tag

Author List Gretchen A. Colbenson, Leah Soderberg

Category Clinical Vignettes

Concept Buprenorphine Microinduction

Concept Buprenorphine

Concept Buprenorphine-precipitated Opioid Withdrawal

Concept Opioid Use Disorder

Concept Full Opioid Agonists

Distinguished Non-Finalist

Presenter Organization Mayo Clinic

Presenting Author Leah Soderberg

Track Adult

Keywords

buprenorphine microdosing

opioid use disorder

inpatient treatment

buprenorphine-naloxone

precipitated withdrawal

hydromorphone taper

pain management

hospitalized patients

opioid agonists

addiction follow-up

Buprenorphine Microinduction

Buprenorphine

Buprenorphine-precipitated Opioid Withdrawal

Opioid Use Disorder

Full Opioid Agonists