Key Aspects and Considerations
Standard induction
Mild to Moderate Withdrawal Symptoms
Cessation of Full Agonist Opioids
Variable Timing
The timing for starting buprenorphine depends on factors such as the type of opioid previously used, the frequency of use, and the method of administration.
A certain level of mild to moderate opioid withdrawal symptoms is necessary before starting buprenorphine.
Patients must completely stop using full agonist opioids before initiating buprenorphine treatment.
Next
Strategy Option 1
Standard induction
Click on the numbers for more information. Click image to enlarge.
This is an example of a patient-facing guide for the standard induction of buprenorphine. It is the more gradual of the two options.
Standard Induction Patient Guide
A resource provided by IT MATTTRs
Next
Strategy Option 2
Standard induction
Click on the image to enlarge.
This is another example of a patient-facing guide for the standard induction of buprenorphine. This option starts with a higher dose than the first option.
Buprenorphine Self-Start Guide
A resource provided by the California Bridge Program
Administer Buprenorphine
At this point, administer 4 mg of buprenorphine and wait 1 hour, at which time, if you feel fine, you relax. If you have ongoing withdrawal symptoms, you take an additional 4 mg. You would repeat this process every 1-2 hours with a maximum first daily dose of 16 mg.
Schedule
You may note that there is a schedule to call and check in with your provider or staff, which is a great option if you are able to do it, but not completely necessary for you or the patient as long as they have some option of communication during the induction if they have questions, or, as mentioned, experience precipitated withdrawal.
Stop Taking Opioids & Check Symptoms
Day 1 starts by offering both the suggestion of waiting 12-36 hours AND a check list for at least 3 objective symptoms. This suggests a SOWS score of greater than or equal to 17.
Day 2
The maximum dose listed on Day 2 is 20 mg, but you may go to 24 mg on Day 2 based on symptoms and past experience. Patients are often experts in this area and know what works for them and how to get there. The providers job is to help keep them safe and support the process.
Standard Induction
veena.radhakrishnan
Created on June 26, 2024
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Transcript
Key Aspects and Considerations
Standard induction
Mild to Moderate Withdrawal Symptoms
Cessation of Full Agonist Opioids
Variable Timing
The timing for starting buprenorphine depends on factors such as the type of opioid previously used, the frequency of use, and the method of administration.
A certain level of mild to moderate opioid withdrawal symptoms is necessary before starting buprenorphine.
Patients must completely stop using full agonist opioids before initiating buprenorphine treatment.
Next
Strategy Option 1
Standard induction
Click on the numbers for more information. Click image to enlarge.
This is an example of a patient-facing guide for the standard induction of buprenorphine. It is the more gradual of the two options.
Standard Induction Patient Guide A resource provided by IT MATTTRs
Next
Strategy Option 2
Standard induction
Click on the image to enlarge.
This is another example of a patient-facing guide for the standard induction of buprenorphine. This option starts with a higher dose than the first option.
Buprenorphine Self-Start Guide A resource provided by the California Bridge Program
Administer Buprenorphine
At this point, administer 4 mg of buprenorphine and wait 1 hour, at which time, if you feel fine, you relax. If you have ongoing withdrawal symptoms, you take an additional 4 mg. You would repeat this process every 1-2 hours with a maximum first daily dose of 16 mg.
Schedule
You may note that there is a schedule to call and check in with your provider or staff, which is a great option if you are able to do it, but not completely necessary for you or the patient as long as they have some option of communication during the induction if they have questions, or, as mentioned, experience precipitated withdrawal.
Stop Taking Opioids & Check Symptoms
Day 1 starts by offering both the suggestion of waiting 12-36 hours AND a check list for at least 3 objective symptoms. This suggests a SOWS score of greater than or equal to 17.
Day 2
The maximum dose listed on Day 2 is 20 mg, but you may go to 24 mg on Day 2 based on symptoms and past experience. Patients are often experts in this area and know what works for them and how to get there. The providers job is to help keep them safe and support the process.