Visiting Nurse Services-facilitated Outpatient Low-dose Buprenorphine Initiation and Engagement in Severe Mental Illness and Ongoing Fentanyl Use: A Case Report

Background and Objectives: Outpatient low-dose buprenorphine initiation (LDBI) is challenging for individuals with severe mental illness and poor treatment adherence. Visiting nurse services (VNS) may support LDBI in these complex patients. Methods: We present a 64-year-old male with opioid use disorder, schizoaffective disorder, and post-traumatic stress disorder who underwent outpatient LDBI supported by VNS. Results: VNS managed medication administration and adherence monitoring, facilitating successful LDBI and sustained engagement. Discussion and Conclusions: VNS facilitated outpatient LDBI and buprenorphine treatment engagement in a patient with fluctuating psychiatric illness and ongoing fentanyl use. Scientific Significance: This case suggests that VNS may facilitate outpatient LDBI and engagement among clinically complex patients in the fentanyl era.