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Essential Site Maintenance
: Authorea-powered sites will be updated circa 15:00-17:00 Eastern on Tuesday 5 November.
There should be no interruption to normal services, but please contact us at
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Timothy Joslin
Family Medicine Physician
Portland, OR
Public Documents
1
AMBULATORY MICRO-DOSE INDUCTION OF BUPRENORPHINE-NALOXONE IN TWO ADOLESCENT PATIENTS...
Bradley Buchheit
and 3 more
June 15, 2020
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 has been described as an alternative option to treat chronic pain in the adult literature, however, it historically has required discontinuation of full-agonist opioids before initiation, resulting in opioid withdrawal symptoms. Here we present two adolescents with SCD who successfully weaned off large doses of full-agonist opioids by using a micro-dose induction of buprenorphine-naloxone in clinic without patients experiencing withdrawal symptoms. Ambulatory micro-dose induction may remove hurdles that otherwise would discourage patients from trying this regimen while still controlling pain safely.