Template:Suboxone protocol
Revision as of 09:23, 4 July 2024 by Ostermayer (talk | contribs) (Created page with "*For [https://www.mdcalc.com/cows-score-opiate-withdrawal Clinical Opioid Withdrawal Scale] (COWS) >=8: 4 to 8mg, observe 30 to 45min, redose if COWS remains >=8. Then discharge home with 16 mg a day to bridge until follow-up (an X-waiver is no longer required to prescribe buprenorphine). *For Clinical Opioid Withdrawal Scale (COWS) 0-7: Consider observing the patient until their COWS score is >8 for the standard buprenorphine induction. Alternatively, you can prescribe...")
- For Clinical Opioid Withdrawal Scale (COWS) >=8: 4 to 8mg, observe 30 to 45min, redose if COWS remains >=8. Then discharge home with 16 mg a day to bridge until follow-up (an X-waiver is no longer required to prescribe buprenorphine).
- For Clinical Opioid Withdrawal Scale (COWS) 0-7: Consider observing the patient until their COWS score is >8 for the standard buprenorphine induction. Alternatively, you can prescribe consider unobserved home induction instructions available on paper [1][2] and app[3] [4].
- If sublingual tablets/films unavailable then intravenous/intramuscular formulation (dose 0.3-0.9 mg every 6-12 hours) has been used for opioid withdrawal in the ED[5] and hospitalized[6] patients.
NIH National Institute on Drug Abuse ED Buprenorphine algorithm[7]
- ↑ A Guide for Patients Beginning Buprenorphine Treatment at Home https://medicine.yale.edu/edbup/quickstart/Home_Buprenorphine_Initiation_338574_42801_v1.pdf
- ↑ A Patient’s Guide to Starting Buprenorphine at Home from ASAM https://www.asam.org/docs/default-source/education-docs/unobserved-home-induction-patient-guide.pdf
- ↑ Buprenorphine Home Induction Apple App Store https://apps.apple.com/us/app/buprenorphine-home-induction/id1449302173
- ↑ Starting Buprenorphine from Google Play Store https://play.google.com/store/apps/details?id=com.amstonstudio.bup&hl=en_US&gl=US
- ↑ Berg ML, et. al. Evaluation of the use of buprenorphine for opioid withdrawal in an emergency department. Drug Alcohol Depend. 2007 Jan 12;86(2-3):239-44. https://doi.org/10.1016/j.drugalcdep.2006.06.014. Epub 2006 Aug 22. PMID: 16930865.
- ↑ Welsh CJ, Suman M, Cohen A, et al. The use of intravenous buprenorphine for the treatment of opioid withdrawal in medically ill hospitalized patients. Am J Addict. 2002;11(2):135-40 https://doi.org/10.1080/105500490290087901
- ↑ https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/algorithm.pdf