Low-dose Buprenorphine Initiation in an Intubated and Sedated Patient: A Case Report.

IF 3.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2025-11-01 Epub Date: 2025-03-27 DOI:10.1097/ADM.0000000000001488
Jessica Moore, Andrew Gangemi
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Abstract

Buprenorphine is a partial opioid agonist effective for the treatment of opioid use disorder. However, precipitated opioid withdrawal remains a barrier to its initiation. As opioid use disorder and related complications continue at alarming rates, it is crucial to evaluate alternative means of initiating this lifesaving medication whenever patients interact with the health care system. In this case report, we discuss a patient who completed low-dose buprenorphine initiation while intubated and sedated in an intensive care setting, in the setting of recent chart documentation of a desire to initiate buprenorphine. Upon extubation, the patient elected to continue buprenorphine. We discuss potential advantages, ethical considerations, and patient perspectives related to initiating buprenorphine in this manner.

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低剂量丁丙诺啡在插管镇静患者中的起始:1例报告。
丁丙诺啡是一种部分阿片类药物激动剂,对治疗阿片类药物使用障碍有效。然而,阿片类药物的沉淀戒断仍然是其启动的障碍。由于阿片类药物使用障碍和相关并发症继续以惊人的速度发展,每当患者与卫生保健系统相互作用时,评估开始使用这种救命药物的替代方法至关重要。在本病例报告中,我们讨论了一位在重症监护环境中插管和镇静时完成低剂量丁丙诺啡起始治疗的患者,在最近的病历文件中显示了开始使用丁丙诺啡的愿望。拔管后,患者选择继续使用丁丙诺啡。我们讨论了以这种方式启动丁丙诺啡的潜在优势、伦理考虑和患者观点。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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