Low-Dose Buprenorphine Initiation in Acute Burn Setting, a Retrospective Chart Review.

Area of Science:

• Medical Research
• Burn Injury Management
• Addiction Medicine

Background:

• Opioid use disorder (OUD) presents significant challenges for pain management, particularly in patients with severe injuries like burns.
• Buprenorphine is a cornerstone of OUD treatment, but its peri-operative use in surgical patients with high pain levels was historically concerning due to potential withdrawal or inadequate pain control.

Purpose of the Study:

• To evaluate the safety and efficacy of initiating low-dose buprenorphine in patients with OUD experiencing acute burn injuries.
• To assess the impact of buprenorphine initiation on pain management and precipitated withdrawal in this specific patient population.

Main Methods:

• Retrospective cohort review of patients with OUD and acute burn injuries who were initiated on low-dose buprenorphine.
• Analysis of pain control, precipitated withdrawal symptoms, and subsequent opioid prescribing patterns.

Main Results:

• The majority of patients (86%) successfully initiated low-dose buprenorphine without adverse effects on pain management or precipitated withdrawal.
• All patients who initiated buprenorphine were able to transition to outpatient OUD care.
• Buprenorphine initiation was associated with reduced opioid prescribing at discharge, with only 50% requiring a short-acting opioid taper.

Conclusions:

• Low-dose buprenorphine can be safely initiated in the acute burn injury setting for patients with OUD.
• This approach facilitates continued OUD treatment and may reduce overall opioid exposure.
• Further research is needed on long-term outcomes and comprehensive management strategies for co-occurring substance use disorder and burn injuries.