Use of High Dose Buprenorphine for the Treatment of Opioid Use Disorder

The final clinical considerations that emerged from the report include:
• Some patients with high opioid tolerance may require buprenorphine doses >24 mg per day during the stabilization phase of treatment.
• Physiological changes during pregnancy alter buprenorphine metabolism, necessitating an adjusted buprenorphine dose and increased dosing frequency.
• Dose and frequency adjustments, psychosocial supports, and a higher level of care should be considered if individuals are unable to stabilize on < 24 mg/day buprenorphine.
• Reassessment of higher (>24 mg/day) doses should be considered once patients enter long-term treatment without ongoing use of opioids.

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