Buprenorphine Rescue in Acute Opioid Toxicity: An Alternative to Naloxone Infusion

Following an opioid overdose, repeated doses of naloxone are often administered in the Emergency Department (ED) for recurrent opioid toxicity. Naloxone infusions are often started after several doses of naloxone, which are challenging to titrate, can lead to sustained periods of precipitated withdrawal, and often result in hospital admission. In this case report, we use initiation of buprenorphine as an alternative to a naloxone infusion following acute opioid toxicity in the ED while also demonstrating the transition of care of Opioid Use Disorder (OUD) in the ED setting to long-term outpatient management. Currently, we see high rates of recurrent opioid toxicity post naloxone administration in this setting, emphasizing the need for an alternative approach.