Buprenorphine Induction for Opioid Use Disorder

Children’s Hospital Colorado’s buprenorphine induction clinical pathway provides guidance on the management of patients with opioid use disorder (OUD) who are indicated for and consent to medication treatment for withdrawal symptoms or OUD. The pathway:

• Offers a standardized approach in the management of opioid withdrawal and buprenorphine treatment, which has documented benefit in supporting patients continued recovery from OUD.
• Optimizes care for patients experiencing opioid withdrawal.
• Provides clear next steps for outpatient management to further encourage recovery.

Buprenorphine Induction for Opioid Use Disorder Clinical Pathway

• Buprenorphine Induction for Opioid Use Disorder

About our Buprenorphine Induction for Opioid Use Disorder Clinical Pathway

The buprenorphine induction pathway offers best practice recommendations for medication-assisted treatment of patients with opioid use disorder. The pathway was created by a multidisciplinary team of content and process experts, including partners from the University of Colorado Anschutz Medical Campus (CU Anschutz) and Denver Health. Our team reviewed available published literature, the CU Anschutz adult pathway and existing processes within Children’s Colorado in the development of this pathway.

The pathway uses the best available evidence to offer a standardized approach to caring for patients who are indicated for and consent to treatment with buprenorphine for opioid withdrawal. 

Highlights include:

• Medication options for symptom management prior to buprenorphine induction
• Standards for buprenorphine induction and maintenance.
• Standards for withdrawal monitoring with the Clinical Opiate Withdrawal Scale (COWS).
• Standardized discharge instructions and procedures, including the provision of intranasal naloxone in hand for each patient and a two-week bridge prescription of buprenorphine to continue the patient’s treatment prior to entering outpatient support.
• Support for outpatient referral of patients to continue their recovery.

The goal of the Agile MD format for these clinical pathways is to optimize evidence-based care for patients while improving workflow and enhancing the care team dynamic.