Related Experiment Video
Updated: Jul 9, 2025

Less-Invasive Technique for Non-stabilized Mandibular Fracture in Mouse Models
Published on: September 27, 2024
Pain Management in Patients With Opioid Use Disorder on Extended-release Buprenorphine: A Case Report
Anna-Maria South1, Devin Oller, Michelle Lofwall
1From the Department of Internal Medicine, Division of Hospital Medicine, Addiction Consult and Education Service, University of Kentucky College of Medicine, Lexington, KY (A-MS); Department of Internal Medicine, Division of General Internal Medicine, Addiction Consult and Education Service, University of Kentucky, College of Medicine, Lexington, KY (DO); Departments of Behavioral Science and Psychiatry, First Bridge and Straus Clinics, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY (ML); Department of Internal Medicine, Division of Infectious Diseases, Addiction Consult and Education Service, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, KY (LCF).
Abstract:
Persons with opioid use disorder (OUD) are receiving extended-release buprenorphine (ER-buprenorphine) for treatment of OUD. There are no clinical guidelines for management of patients with OUD on ER-buprenorphine experiencing acute or chronic pain. This case report describes 3 patient-involved, multidisciplinary approaches for pain management in various clinical scenarios, including a scheduled knee replacement, emergent surgery for an ischemic limb, and management of chronic pain from metastatic malignancy. These cases illustrate that adequate analgesia for patients who have received ER-buprenorphine is possible, and approaches can be individualized, with shared decision making between providers and patients addressing all barriers to optimize treatment outcomes. Options for acute pain management that can be considered include supplemental sublingual buprenorphine, nonopioid adjuncts, and short courses of full opioid agonists. Potential barriers that impact OUD and acute/chronic pain are provider bias, limited access to palliative care clinicians with addiction medicine training, and payor restrictions to adding sublingual buprenorphine for patients that are on ER-buprenorphine. Additional training for clinicians and other members of the health care team is recommended to improve patient-involved care of persons with OUD experiencing pain.
Related Concept Videos
Opioid Analgesics: Synthetic and Semisynthetic Opioids
Analgesia and Pain Management
Opioid Analgesics: Morphine and Other Natural Cogeners
Opioid Receptors: Overview
Drugs for Treatment of Constipation-Predominant IBS
Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...

