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Dangers of Buprenorphine Dose Limits

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Official guidelines on Buprenorphine dosing recommend a top daily dose of 16 to 24 mg, with disregard for evidence showing that some people require higher doses for stability. Some prescribers use these guidelines to arbitrarily limit patients to 16 mg per day. In the age of widespread Fentanyl use, many people need higher doses to avoid withdrawal symptoms and achieve stable abstinence. In this workshop we will discuss Buprenorphine dosing strategies and instructions for patients and their families to promote optimal outcomes. We will highlight nursing and advanced practice roles for efficiently and compassionately managing opioid use disorder patients. Objectives Identify five indicators of Buprenorphine dose adequacy for each individual patient. Develop essential instructions for patients regarding best practices for optimal sublingual Buprenorphine administration. Presenter MaryAnne C. Murray, DNP, EdD, PMHNP-BC, FNP-BC, CARN-AP; Smart Moves Integrated Health Services; Ilwaco, Washington MaryAnne trained in Addiction Studies at Seattle University, then provided mental health and substance use disorder (SUD) care in an HIV/AIDS clinic during nursing school. While managing a hospital-based detox unit and treatment program for pregnant persons with addictions, she trained other health professionals to provide addiction care. Dr. Murray has worked in residential treatment, rural primary care, a Methadone program, and served eight years at a rural, remote community mental health center where she created a Medications for Addiction Treatment (MAT) program. She currently precepts Psychiatric/Mental Health Nurse Practitioner students for multiple universities in Washington State and beyond.
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