Contributor: Don Stader, MD

Educational Pearls:

• Buprenorphine has been shown to decrease morbidity and mortality in opioid use disorder
• Buprenorphine used in naloxone-induced withdrawals can displace naloxone at opioid receptors, leading to reduced withdrawal symptoms and lessen the chance of using after discharge
• Patients in acute withdrawal due to naloxone after an overdose should be given Buprenorphine. Data shows that withholding Buprenorphine leads to increased mortality rates of 5% within the following month, and 10% in the following year.

References

1. Herring, Andrew. "Emergency Department Medication-Assisted Treatment of Opioid Addiction." Chcf.org, Aug. 2016, www.chcf.org/wp-content/uploads/2017/12/PDF-EDMATOpioidProtocols.pdf.
2. D.H. Cisewski et al. Approach to buprenorphine use for opioid withdrawal treatment in the emergency setting. American Journal of Emergency Medicine 37 (2019) 143–150

Summarized by Jackson Roos, MS4 | Edited by Erik Verzemnieks, MD