期刊
JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
卷 34, 期 -, 页码 S141-S146出版社
AMER BOARD FAMILY MEDICINE
DOI: 10.3122/jabfm.2021.S1.200236
关键词
Buprenorphine Naloxone; COVID-19; Opioid Addiction; Pain; Pandemics; Telemedicine
Using buprenorphine therapy to transition patients from high-dose opioids can improve treatment outcomes, simplify processes, reduce healthcare visits, and prevent unnecessary hospital admissions during the COVID-19 pandemic.
Prescription opioid dependence remains a major source of morbidity and mortality in the United States. Patients previously on high-dose opioids may poorly tolerate opioid tapers. Current guidelines support the use of buprenorphine therapy in opioid-tapering protocols, even among patients without a diagnosis of opioid use disorder. Buprenorphine microinduction protocols can be used to transition patients to buprenorphine therapy without opioid withdrawal. From November 2019 to April 2020, we transitioned 8 patients on high-dose prescribed opioids for pain to sublingual buprenorphine-naloxone using a microdose protocol without any evidence of precipitated withdrawal. Six of these patients remain on buprenorphine-naloxone and report improved analgesia. Because of its simplicity, the buprenorphine microinduction protocol can be easily adapted for telemedicine and may help to prevent unnecessary clinic visits and opioid-related admissions in the setting of social distancing regulations during the coronavirus 2019 pandemic.
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