buprenorphine has lower risk of respiratory suppression
- related: opioid management inpatient
- tags: #literature #icu
This patient took an opioid in larger amounts than prescribed, resulting in an overdose, which is clear evidence of harm. However, OUD cannot be diagnosed on the basis of this one event alone. Further evaluation is needed to better assess for OUD. In the meantime, buprenorphine may be helpful as a harm-reduction strategy to mitigate the patient’s risk of overdose; this drug has a ceiling effect on respiration and thus carries a low risk of overdose.
Although buprenorphine does cause respiratory depression, this effect does not increase at higher doses, so the risk of unintentional overdose is not as high. Notably, the relative advantage of buprenorphine with regard to respiratory depression is lost when the medication is taken with other respiratory depressants such as benzodiazepines or alcohol.
In terms of other opioid-related adverse effects, data suggest that buprenorphine may result in less relative constipation and analgesic tolerance than other pure mu opioids.