Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.

Buprenorphine possesses many unique attributes that make it a practical agent for adults and adolescents with opioid use disorder (OUD) and/or acute or chronic pain. Sublingual buprenorphine has been the standard of care for treating OUD, but its use in pain management is not as clearly defined. Current practice guidelines recommend a period of mild-to-moderate withdrawal from opioids before transitioning to buprenorphine due to its ability to displace full agonists from the μ-opioid receptor.

Comparing Methadone Rotation to Consensus Opinion.

Context: Methadone is a complex but useful medication for pain management in palliative care. Recent expert opinions have been published on the safe and effective use of methadone.

Objectives: To determine the success of methadone rotations and evaluate concordance with consensus recommendations by a palliative care consult service.