Buprenorphine Inductions via Transdermal Patches for Opioid Use Disorder in the Inpatient Setting

Buprenorphine inductions traditionally require an opioid-free period due to the risk of precipitated opioid withdrawal. Hospitalized patients with opioid use disorder and concurrent acute pain may be eligible for buprenorphine therapy. However, effective buprenorphine induction strategies in this patient population have not been well established. Investigators sought to review the completion of a low dose induction protocol that does not require an opioid-free period prior to buprenorphine initiation. Hospitalized patients who completed a 7-day low dose induction protocol via buprenorphine transdermal patches October 2021 - March 2022 were examined via retrospective chart review (N = 7). All seven patients completed the induction and were discharged on sublingual buprenorphine. Low dose transdermal buprenorphine provides a reasonable strategy for hospitalized patients on full agonist opioid therapy or those who have failed conventional buprenorphine induction strategies. Reducing barriers such as opioid abstinence is key to combating opioid use disorder.