@article{TEXTUAL,
      recid = {6265},
      author = {Murray, John P. and Pucci, Geoffrey and Weyer, George and  Ari, Mim and Dickson, Sarah and Kerins, Angela},
      title = {Low dose IV buprenorphine inductions for patients with  opioid use disorder and concurrent pain: A retrospective  case series},
      journal = {Addiction Science &amp; Clinical Practice},
      address = {2023-06-01},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Background: Hospitalizations are a vital opportunity  for the initiation of life-saving opioid agonist therapy  (OAT) for patients with opioid use disorder. A novel  approach to OAT initiation is the use of IV buprenorphine  for low dose induction, which allows patients to  immediately start buprenorphine at any point in a  hospitalization without stopping full agonist opioids or  experiencing significant withdrawal.&lt;/p&gt; &lt;p&gt;Methods: This  is a retrospective case series of 33 patients with opioid  use disorder concurrently treated with full agonist opioids  for pain who voluntarily underwent low dose induction at a  tertiary academic medical center. Low dose induction is the  process of initiating very low doses of buprenorphine at  fixed intervals with gradual dose increases in patients who  recently received or are simultaneously treated with full  opioid agonists. Our study reports one primary outcome:  successful completion of the low dose induction (i.e.  transitioned from low dose IV buprenorphine to sublingual  buprenorphine-naloxone) and three secondary outcomes:  discharge from the hospital with buprenorphine-naloxone  prescription, self-reported pain scores, and  nursing-assessed clinical opiate withdrawal scale (COWS)  scores over a 6-day period, using descriptive statistics.  COWS and pain scores were obtained from day 0 (prior to  starting the low dose induction) to day 5 to assess the  effect on withdrawal symptoms and pain control.&lt;/p&gt;  &lt;p&gt;Results: Thirty patients completed the low dose  induction (30/33, 90.9%). Thirty patients (30/33, 90.9%)  were discharged with a buprenorphine prescription. Pain and  COWS scores remained stable over the course of the study  period. Mean COWS scores for all patients were 2.6 (SD 2.8)  on day 0 and 1.6 (SD 2.6) on day 5. Mean pain scores for  all patients were 4.4 (SD 2.1) on day 0 and 3.5 on day 5  (SD 2.1).&lt;/p&gt; &lt;p&gt;Conclusions: This study found that an IV  buprenorphine low dose induction protocol was  well-tolerated by a group of 33 hospitalized patients with  opioid use disorder with co-occurring pain requiring full  agonist opioid therapy. COWS and pain scores improved for  the majority of patients. This is the first case series to  report mean daily COWS and pain scores over an extended  period throughout a low dose induction process.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/6265},
}