CA-Bridge Buprenorphine Hospital Quick Start Algorithm - Management of acute opiate withdrawal - Any prescriber can order Bup in the hospital, even without an x-waiver. - Bup is a high-affinity, partial agonist opioid that is safe and highly effective for treating opioid use disorder. - If patient is stable on methadone or prefers methadone, recommend continuation of methadone as first-line treatment. Buprenorphine Dosing: - Either Bup or Bup/Nx (buprenorphine/naloxone) films or tab sublingual (SL) are OK. - If unable to take oral/SL, try Bup 0.3mg IV/IM. - OK to start with lower initial dose: Bup 2-4mg SL. - Total initial daily dose above 16mg may increase duration of action beyond 24 hrs. - Bup SL onset 15 min, peak 1 hr, steady state 7 days - May dose qday or if co-exisiting chronic pain split dosing TID/QID #Management #Opioid #Withdrawal #Emergency #Buprenorphine #Treatment #Algorithm #Addiction #Prescribing
