High-dose buprenorphine protocol well tolerated in patients with untreated opioid use disorder; no reports of respiratory depression or sedation<\/p>\n<\/h3>\n
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FRIDAY, July 16, 2021 (HealthDay News) — For patients with untreated opioid use disorder (OUD) presenting to the emergency department, high-dose buprenorphine induction seems safe and is well tolerated, according to a study published online July 15 in JAMA Network Open<\/em>.<\/p>\n Andrew A. Herring, M.D., from the Highland Hospital-Alameda Health System in Oakland, California, and colleagues examined the safety and tolerability of high-dose (>12 mg) buprenorphine induction in a case series of patients presenting to the emergency department with OUD. Data were included for 391 unique patients, representing 579 encounters.<\/p>\n During 366 encounters, 54 unique clinicians administered a high dose of sublingual buprenorphine, including 138 doses that were \u00e2\u0089\u00a528 mg. The researchers observed no cases of respiratory depression or sedation. No association with dose was seen for the five cases of precipitated withdrawal (0.8 percent); four cases occurred after doses of 8 mg of buprenorphine. There were three serious adverse events, which were unrelated to buprenorphine. Nausea and vomiting occurred infrequently (2 to 6 percent of cases). Patients had a median length of stay of 2.4 hours.<\/p>\n “The extended opioid blockade provided by the high-dose pathway may impart more substantial overdose protection and more effective blunting of the euphoric and reinforcing effects of any opioids used in the high-risk window following emergency department departure prior to engagement in follow-up care,” the authors write.<\/p>\n One author disclosed financial ties to the biopharmaceutical industry.<\/p>\n