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Buprenorphine/Naloxone

Opioid use disorder (OUD), Opioid withdrawal management, ED-initiated buprenorphine for OUD

Indications

  • Opioid use disorder (OUD)
  • Opioid withdrawal management
  • ED-initiated buprenorphine for OUD

Adult dosing

  • induction: dose: 4; unit: mg SL; route: Sublingual; interval: May re-dose 4mg SL q1-2h; target 8-16mg on day 1; fixed: true; maintenance: dose: 16; unit: mg SL; route: Sublingual daily; interval: Range 8-24mg daily; fixed: true

Contraindications

  • Active opioid intoxication
  • Severe hepatic impairment

Clinical pearls

  • Wait for COWS ≥8-12 before traditional induction to avoid precipitated withdrawal
  • Low-dose (micro-dosing) induction protocols available for patients unable to tolerate withdrawal
  • ED-initiated buprenorphine doubles treatment engagement at 30 days (D'Onofrio et al., JAMA 2015)
  • X-waiver requirement eliminated in 2023 — any DEA-licensed provider can prescribe
  • Naloxone component prevents IV misuse — inactive when taken sublingually

Source and review

  • SAMHSA TIP 63; D'Onofrio et al., JAMA 2015. Last reviewed: 2024-11-01