PHM-06 - Micro Induction of Buprenorphine in Sickle Cell Pain

While no specific opioid is recommended for SCD chronic pain, buprenorphine continues to be an intriguing option with its unique mechanism of action, lower respiratory depression risk, and long duration of action. Existing literature describing the effect of buprenorphine for SCD chronic pain is mostly qualitative in nature but does show promise with functional improvements, and poses as an option for those dissatisfied with full agonist opioids. Transition to buprenorphine from full agonist opioids remains challenging due to precipitated withdrawal symptoms and the complexity of inducting a patient with co-existing acute crisis pain. One method to overcome this challenge is with a buprenorphine micro-induction. This presentation will focus on an overview of what buprenorphine is, highlight its unique pain pharmacology, and lastly describe how to perform a buprenorphine micro-induction for patients admitted with acute crisis and the subsequent long-term management of chronic pain.