Buprenorphine Induction in Trauma Patients With Opioid Use Disorder - A Single Center Experience?

Area of Science:

• Trauma Surgery
• Addiction Medicine
• Pharmacology

Background:

• Buprenorphine is an effective FDA-approved treatment for opioid use disorder (OUD).
• Low-dose buprenorphine initiation (microinduction) offers a novel approach for patient transition.
• Trauma patients frequently experience OUD and may have patient-directed discharges (PDD).

Purpose of the Study:

• To compare buprenorphine microinduction versus traditional induction in trauma patients.
• To assess the impact of initiation method on protocol completion and PDD.
• To evaluate factors associated with successful buprenorphine induction in trauma care.

Main Methods:

• Retrospective cohort study at an urban level one trauma center (December 2020 - June 2022).
• Included patients aged 18-89 with traumatic injuries receiving buprenorphine.
• Primary outcome: in-hospital protocol completion (16 mg buprenorphine within 24h or stable dose).

Main Results:

• No significant difference in protocol completion between microinduction (46 patients) and traditional induction (52 patients) (P=0.29).
• Overall protocol completion rate was 83%.
• Protocol completers were more likely to be discharged home (P=0.0002), had fewer PDDs (P=0.001), and increased outpatient addiction clinic follow-up (P=0.038).

Conclusions:

• Buprenorphine induction, regardless of protocol type, is feasible in trauma patients with high completion rates.
• Successful buprenorphine induction completion is associated with improved discharge disposition and post-discharge care engagement.
• Findings support the implementation of buprenorphine induction protocols in trauma settings to manage opioid use disorder.