AMBULATORY MICRO-DOSE INDUCTION OF BUPRENORPHINE-NALOXONE IN TWO
ADOLESCENT PATIENTS WITH SICKLE CELL DISEASE
Abstract
Sickle cell disease (SCD) is a hematologic disorder defined by presence
of sickle-shaped red blood cells that can occlude blood vessels and
cause tissue ischemia and pain. Treating SCD pain adequately and safely
is difficult given today’s opioid climate. Buprenorphine-naloxone is
described in adult literature where it typically requires withdrawal of
full-agonist opioids and inpatient hospitalization. Here we present two
adolescents with SCD who successfully weaned off large doses of
full-agonist opioids by using micro-dose induction of
buprenorphine-naloxone in clinic. Ambulatory micro-dose induction may
remove hurdles that otherwise would discourage patients from trying this
regimen while still controlling pain safely.