Buprenorphine/naloxone micro-induction in a tertiary care hospital: a retrospective cohort analysis
Bibliographic record
Abstract
OBJECTIVES: To describe the use of buprenorphine/naloxone micro-inductions in hospitalized patients and characterize the success rate of these inductions. METHODS: We conducted a retrospective chart review of hospitalized patients receiving a buprenorphine/naloxone micro-induction for opioid use disorder in a tertiary care hospital from Jan 2020-Dec 2020. The primary outcome was a description of the micro-induction prescribing patterns used. The secondary outcomes were a description of the demographic characteristics of patients, the estimated frequency of withdrawal symptoms experienced by patients undergoing a micro-induction, and the overall success rate of the micro-inductions defined as retention on buprenorphine/naloxone therapy with no precipitated withdrawal experienced. RESULTS: Thirty-three patients were included in the analysis. Three main micro-induction regimens were identified, including rapid micro-inductions (8 patients), 0.5 mg SL BID initiations (6 patients), and 0.5 mg SL daily initiations (19 patients). Twenty-four patients (73%) met the criteria for a successful micro-induction, defined as being retained in buprenorphine/naloxone therapy with no precipitated withdrawal experienced. The most common reason for micro-induction failure was patient request to discontinue buprenorphine/naloxone therapy due to perceived adverse effects or personal preference. CONCLUSION: Buprenorphine/naloxone micro-induction in hospitalized patients resulted in a majority of patients being successfully initiated on buprenorphine/naloxone therapy without requiring opioid abstinence prior to induction. Dosing regimens were variable, and the ideal regimen remains unclear.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".