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

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.