Hospital-based Buprenorphine/Naloxone Initiation in a Patient With Limited Communication Abilities: A Case Report

North America's opioid crisis highlights the profound need for low-barrier access to opioid agonist therapy (OAT) for the treatment of opioid use disorder (OUD). This case describes a 33-year-old female with a history of opioid and stimulant use disorder admitted to hospital after a left middle cerebral artery ischemic stroke with resulting aphasia. After medical stabilization, she consented to buprenorphine/naloxone through limited verbal and written communication. After 14 days of titration, she was stabilized on 14 to 3.5 milligrams of buprenorphine/naloxone daily. Buprenorphine/naloxone initiation and titration is patient-based and symptom guided, typically requiring active communication between the patient and care provider. This case illustrates successful buprenorphine/naloxone initiation in a patient with limited receptive and expressive language abilities, emphasizing the feasibility of offering this medication to individuals with limited communication to ensure timely access to evidence-based OUD treatment.