SHM Converge Scientific Abstract ePoster Gallery-Iv Buprenoprhine for Microinduction: A Case Series

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This retrospective case series evaluated an intravenous (IV) buprenorphine microinduction protocol for hospitalized patients with opioid use disorder. Buprenorphine is effective and life-saving, but inpatient initiation is often limited by provider inexperience, stigma, the need for patients to already be in withdrawal, and complications from acute pain or fentanyl exposure. Microinduction uses very low, gradually increasing doses so patients can start buprenorphine without waiting for significant withdrawal and may continue full agonist opioids during the transition.<br /><br />Researchers reviewed all IV microinductions over 10 months and identified 49 eligible patients. Two dosing approaches were used: a standard regimen dosed every 6 hours and a slower regimen dosed every 12 hours, both aiming to transition to sublingual buprenorphine by day 3 or 4. COWS (withdrawal) and pain scores were tracked over six days.<br /><br />The protocol was successful in 46 of 49 patients (93.9%), with only one self-directed discharge. Mean COWS scores were low throughout and decreased overall, from 2.97 on day 0 to 1.69 on day 5. Pain scores also remained stable, decreasing slightly from 3.62 to 3.06 over the same period. <br /><br />Overall, the findings suggest that IV buprenorphine microinduction was well tolerated and did not meaningfully worsen withdrawal or pain. The authors conclude that it is a promising inpatient strategy for initiating buprenorphine, especially in patients receiving opioids for pain or those exposed to fentanyl.

Asset Subtitle

John P. Murray

Meta Tag

Author List Angela Kerins, Geoffrey Pucci, George Weyer, John P. Murray, Mim Ari, Sarah B. Dickson

Category Research

Concept Intravenous Buprenorphine Microinduction

Concept Buprenorphine

Concept Opioid Use Disorder

Concept Buprenorphine-precipitated Opioid Withdrawal

Concept Full Opioid Agonists

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author John P. Murray

Track Translating Research into Practice

Keywords

intravenous buprenorphine

microinduction

opioid use disorder

hospitalized patients

inpatient initiation

withdrawal management

fentanyl exposure

sublingual buprenorphine

pain scores

retrospective case series

Intravenous Buprenorphine Microinduction

Buprenorphine

Opioid Use Disorder

Buprenorphine-precipitated Opioid Withdrawal

Full Opioid Agonists