Related Experiment Video
Updated: Sep 20, 2025
11:02
Author Spotlight: Investigating Cellular and Molecular Dynamics During Muscle Regeneration Using Cutting-Edge Single-Cell Technologies
Published on: December 1, 2023
1.2K
Treatment Experience Using a Micro-Induction Buprenorphine Protocol for Chronic Pain in Pediatric Sickle Cell Disease
Ashwin Patel1,2, Grace Kalmus2, Carlton Dampier1,2
1Emory University School of Medicine, Atlanta, Georgia, USA.
Pediatric Blood & Cancer
|May 24, 2025
Summary
Transitioning pediatric sickle cell disease patients with chronic pain to buprenorphine (BUP) is feasible. This approach reduced acute care use and opioid medication needs, offering a harm reduction strategy.
Area of Science:
- Pediatric Hematology
- Pain Management
- Pharmacology
Background:
- Sickle cell disease (SCD) patients often develop chronic pain (CP) inadequately managed by standard guidelines.
- Buprenorphine (BUP), a partial opioid agonist, offers a harm reduction approach for CP due to its safety profile.
- BUP has less euphoria and a respiratory ceiling effect, making it suitable for pediatric patients.
Purpose of the Study:
- To assess the feasibility of transitioning adolescents with SCD and CP from full opioid agonists (FOA) to BUP.
- To evaluate the safety and tolerability of inpatient BUP induction and maintenance therapy.
- To compare acute care utilization and opioid use pre- and post-BUP transition.
Main Methods:
- Retrospective study of 14 adolescents (12-20 years) with SCD and CP transitioning to BUP.
- Inpatient micro-induction approach from FOA to BUP.
- Comparison of acute care utilization, hospital length of stay, and FOA use over one year pre- and post-BUP.
Main Results:
- Inpatient BUP transition was feasible and well-tolerated, with low adverse events like opioid withdrawal.
- BUP maintenance was sustainable for most patients over the 1-year follow-up.
- Significant reductions in acute care utilization, hospital length of stay, and FOA use were observed.
Conclusions:
- Inpatient micro-induction of buprenorphine (BUP) is a feasible and safe method for adolescents with sickle cell disease and chronic pain.
- This transition strategy shows promise in reducing acute care utilization and opioid dependence.
- BUP offers an effective harm reduction strategy for managing chronic pain in pediatric SCD patients.
Related Concept Videos
01:25Analgesia and Pain Management
827
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
827
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
455
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
455