Micro-induction and how to prevent precipitated withdrawal in the age of synthetic fentanyl analogs

The Poison Control Center’s Opioid Assistance Resource (OAR) organized a 4-part virtual webinar series focusing on prescribing, family and pediatric approaches to opioid use disorder (OUD) care, and the landscape of substance and opioid treatment in Philadelphia.

This series is part of the OAR collection with support from the Health Federation of Philadelphia's Substance Use Response Guidance and Education (SURGE) program

In a view of the fact that avoiding precipitated withdrawal is a priority for both the patient and the provider when starting buprenorphine for the treatment of opioid use disorder, this program Led by Dr. Joseph D'Orazio, MD aimed to review practices to prevent precipitated withdrawal. As the drug supply has become more potent, approaches to buprenorphine have needed to adapt.  While still relevant to patients who are dependent on opioid pills obtained from a pharmacy, the standard induction that was taught as the primary means of buprenorphine initiation during the first few years of the opioid crisis can cause precipitated withdrawal for patients who are dependent to fentanyl. 

Presenter: Dr. Joseph D'Orazio, MD, FAAEM, FACMT

Dr. D'Orazio is a medical toxicologist and serves as the Director of the division of emergency, medical toxicology and addiction medicine at Temple University Hospital, as well as a medical toxicology consultant for Children’s Hospital of Philadelphia. Dr. D'Orazio is active in communicating with other experts in the field about drug supply treating withdrawal with other providers across health systems.

The Poison Control Center at CHOP’s Opioid Assistance Resource: The Poison Control Center at CHOP provides Philadelphia’s medical community with Opioid Assistance Resource support via our 24/7 phone line: 800-222-1222. OAR is here to help you with managing opioid toxicity and initiating buprenorphine for Opioid Use Disorder.