Office-Based Buprenorphine Treatment of Opioid Use Disorder (Online)-M 3 - View Lecture (Clinical Use: Induction, Stabilization, Maintenance, and Withdrawal Part 2)

M 3 - View Lecture (Clinical Use: Induction, Stabilization, Maintenance, and Withdrawal Part 2)

Video Transcription

Video Summary

The video discusses changes in the clinical use of buprenorphine and provides recommendations for its clinical application. It begins by reviewing standard induction protocols for buprenorphine, which include assessing patients for opioid withdrawal symptoms, using an opioid withdrawal scale, and initiating treatment with a two or four milligram buprenorphine naloxone dose. The target dose for the first day is eight milligrams, with the possibility of increasing to 12 milligrams in patients using fentanyl. The video also discusses protocols for patients transitioning from heroin, opioid pharmaceuticals, or methadone to buprenorphine. It outlines various protocols for low-dose and high-dose induction, as well as home inductions, which have become more common in recent years. The video also highlights the use of extended-release naltrexone as an alternative treatment for opioid use disorder, but notes the importance of patient retention and additional support services. In terms of pain management, the video suggests strategies for addressing acute and chronic pain in patients maintained on buprenorphine, including the use of non-opioid alternatives, dividing buprenorphine doses, and supplementing with short-acting opioids if needed. The video emphasizes the importance of avoiding medication interruptions and coordinating pain management with other healthcare providers. Overall, the video provides a comprehensive overview of the clinical use of buprenorphine and offers recommendations for its use in different contexts.

Keywords

clinical use

buprenorphine

induction protocols

opioid withdrawal

transitioning protocols

pain management

extended-release naltrexone