Buprenorphine Is Associated With Lower Home Opioid Use and Acute Care Utilization in Sickle Cell Disease

Sickle cell disease (SCD) is an inherited genetic disorder affecting an estimated 100,000 people in the United States. The hallmark of SCD is acute and chronic pain, which leads to increased healthcare utilization. Pain in SCD is treated with full opioid agonists with variable effectiveness. There is growing evidence supporting buprenorphine in adults with SCD for pain.

The objective of this study was to describe the health outcomes of buprenorphine use in adults with SCD.

This study was a single-center, retrospective cohort study of all individuals with SCD and chronic pain treated with buprenorphine between November 2020 and January 2024. Descriptive statistics and paired t-tests were used to compare health outcomes before and after treatment.

Thirteen inductions were completed, six using telemedicine, two with a diagnosis of opioid use disorder, one individual (7.7%) failed induction and did not continue buprenorphine. Median duration of follow-up was 103 days (range 21-1,497 days). Buprenorphine use was associated with lower annualized rates of emergency department visits (7.2 vs 5.9, -1.3, p < .001), hospital admissions (8.5 vs 5.6, -2.9, p < .001), and treatment center visits (3.0 vs 2.2, -0.9, p < .001), and lower rates of home opioid use (189.3 vs 35.6 morphine milligram equivalent, -153.7, p < .001).

Buprenorphine induction was successful using telemedicine and for those with opioid use disorder. Buprenorphine was associated with lower opioid use and healthcare utilization in patients with SCD and chronic pain.