{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:25:31Z","timestamp":1790720731851,"version":"4.1.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Morbidity and mortality from nonprescribed opioid use and opioid use disorder (OUD) in adolescents have risen dramatically. Medication for opioid use disorder (MOUD) with buprenorphine reduces nonprescribed opioid use and prevents overdoses, though &amp;lt;5% of adolescents with OUD have timely access, partly because of barriers associated with buprenorphine induction. Induction in an inpatient pediatric setting has the potential to address such barriers and improve adolescent MOUD access.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We developed and implemented a protocol for inpatient buprenorphine induction and linkage to MOUD care within a safety-net health system. After 1 year, we conducted descriptive analysis of participant characteristics, rates of induction completion and treatment linkage, and adverse events. We analyzed field notes from multidisciplinary huddles to identify implementation facilitators and barriers.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>During May 2021 to July 2022, we completed 46 admissions for 36 patients aged 12 to 21 years. All used fentanyl and no other opioids. Forty of 46 (87%) admissions resulted in completed induction, and 3 additional patients never developed withdrawal symptoms and were discharged with maintenance buprenorphine. Linkage to ongoing treatment occurred within 2 weeks for 31 of 43 (72%) admissions for which buprenorphine was started. We identified facilitators and barriers to program implementation and maintenance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>These results provide promising preliminary evidence of the feasibility of inpatient buprenorphine induction for adolescents with OUD. Given the public health urgency and severe shortage of adolescent access to MOUD, these results prompt consideration of broader clinical implementation and research to facilitate rapid expansion of access to evidence-based OUD care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/hpeds.2022-006864","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T08:13:54Z","timestamp":1674461634000},"page":"e23-e28","source":"Crossref","is-referenced-by-count":12,"title":["A Novel Inpatient Buprenorphine Induction Program for Adolescents With Opioid Use Disorder"],"prefix":"10.1542","volume":"13","author":[{"given":"Lee A.","family":"Trope","sequence":"first","affiliation":[{"name":"aDepartments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Stemmle","sequence":"additional","affiliation":[{"name":"aDepartments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Chang","sequence":"additional","affiliation":[{"name":"bFamily Medicine, Valley Homeless Healthcare Program"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Bashiri","sequence":"additional","affiliation":[{"name":"cAddiction Medicine, Santa Clara Valley Medical Center, San Jose, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Bazazi","sequence":"additional","affiliation":[{"name":"dDepartments of Psychiatry and Behavioral Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerita","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"eSchool of Public Health, Oregon Health and Science University and Portland State University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayme L.","family":"Congdon","sequence":"additional","affiliation":[{"name":"fPediatrics, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"issue":"11","key":"2023112713581581100_b1","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1001\/jamapediatrics.2018.2143","article-title":"Receipt of timely addiction treatment and association of early medication treatment with retention in care among youths with opioid use disorder","volume":"172","author":"Hadland","year":"2018","journal-title":"JAMA Pediatr"},{"issue":"14","key":"2023112713581581100_b2","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1001\/jama.2022.2847","article-title":"Trends in drug overdose deaths among US adolescents, January 2010 to June 2021","volume":"327","author":"Friedman","year":"2022","journal-title":"JAMA"},{"issue":"2","key":"2023112713581581100_b3","doi-asserted-by":"crossref","first-page":"e20182752","DOI":"10.1542\/peds.2018-2752","article-title":"Youth and the opioid epidemic","volume":"143","author":"Levy","year":"2019","journal-title":"Pediatrics"},{"key":"2023112713581581100_b4","doi-asserted-by":"crossref","first-page":"j1550","DOI":"10.1136\/bmj.j1550","article-title":"Mortality risk during and after opioid substitution treatment: systematic review and meta-analysis of cohort studies","volume":"357","author":"Sordo","year":"2017","journal-title":"BMJ"},{"issue":"3","key":"2023112713581581100_b5","doi-asserted-by":"crossref","first-page":"e20161893","DOI":"10.1542\/peds.2016-1893","article-title":"Medication-assisted treatment of adolescents with opioid use disorders","volume":"138","author":"Committee on Substance Use and Prevention","year":"2016","journal-title":"Pediatrics"},{"key":"2023112713581581100_b6","doi-asserted-by":"crossref","first-page":"108494","DOI":"10.1016\/j.jsat.2021.108494","article-title":"Effectiveness of medication for opioid use disorders in transition-age youth: a systematic review","volume":"132","author":"Becker","year":"2022","journal-title":"J Subst Abuse Treat"},{"issue":"4","key":"2023112713581581100_b7","doi-asserted-by":"crossref","first-page":"e265","DOI":"10.1097\/ADM.0000000000000922","article-title":"Evidence of buprenorphine-precipitated withdrawal in persons who use fentanyl","volume":"16","author":"Varshneya","year":"2022","journal-title":"J Addict Med"},{"issue":"2","key":"2023112713581581100_b8","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1002\/wps.20846","article-title":"The epidemic of fentanyl misuse and overdoses: challenges and strategies","volume":"20","author":"Volkow","year":"2021","journal-title":"World Psychiatry"},{"issue":"3","key":"2023112713581581100_b9","doi-asserted-by":"crossref","first-page":"E73","DOI":"10.1503\/cmaj.74018","article-title":"Buprenorphine-naloxone \u201cmicrodosing\u201d: an alternative induction approach for the treatment of opioid use disorder in the wake of North America\u2019s increasingly potent illicit drug market","volume":"192","author":"Randhawa","year":"2020","journal-title":"CMAJ"},{"issue":"1","key":"2023112713581581100_b10","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.drugpo.2014.07.013","article-title":"High risk and little knowledge: overdose experiences and knowledge among young adult nonmedical prescription opioid users","volume":"26","author":"Frank","year":"2015","journal-title":"Int J Drug Policy"},{"issue":"8","key":"2023112713581581100_b11","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1111\/add.14198","article-title":"An investigation of an open-access model for scaling up methadone maintenance treatment","volume":"113","author":"Madden","year":"2018","journal-title":"Addiction"},{"key":"2023112713581581100_b12","unstructured":"CA Bridge Program. Transforming addiction treatment. Available at: https:\/\/cabridge.org. Accessed September 21, 2022"},{"key":"2023112713581581100_b13","first-page":"540","article-title":"Opioid use disorder","author":"American Psychiatric Association","year":"2013","journal-title":"Diagnostic and Statistical Manual of Mental Disorders"},{"key":"2023112713581581100_b14","author":"California Code","year":"1992","journal-title":"Family Code \u00a7 6929 (e)"},{"key":"2023112713581581100_b15","unstructured":"Opioid Response Network. Opioid response network. Available at: https:\/\/opioidresponsenetwork.org\/. Accessed July 18, 2022"},{"key":"2023112713581581100_b16","unstructured":"CA Bridge. Blueprint for hospital opioid use disorder treatment. Available at: https:\/\/cabridge.org\/resource\/blueprint-for- hospital-opioid-use-disorder-treatment\/. Accessed January 12, 2021"},{"issue":"2","key":"2023112713581581100_b17","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/02791072.2003.10400007","article-title":"The Clinical Opiate Withdrawal Scale (COWS)","volume":"35","author":"Wesson","year":"2003","journal-title":"J Psychoactive Drugs"},{"issue":"1","key":"2023112713581581100_b18","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1177\/1744987107081254","article-title":"Memoing in qualitative research: probing data and processes","volume":"13","author":"Birks","year":"2008","journal-title":"J Res Nurs"},{"issue":"4","key":"2023112713581581100_b19","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1080\/14780887.2015.1021941","article-title":"Combatting challenges to establishing trustworthiness in qualitative research","volume":"12","author":"Kornbluh","year":"2015","journal-title":"Qual Res Psychol"},{"key":"2023112713581581100_b20","doi-asserted-by":"crossref","first-page":"108479","DOI":"10.1016\/j.jsat.2021.108479","article-title":"Emergency department-based efforts to offer medication treatment for opioid use disorder: what can we learn from current approaches?","volume":"129","author":"Stewart","year":"2021","journal-title":"J Subst Abuse Treat"},{"issue":"6","key":"2023112713581581100_b21","doi-asserted-by":"crossref","first-page":"345","DOI":"10.12788\/jhm.3591","article-title":"Hospital buprenorphine program for opioid use disorder is associated with increased inpatient and outpatient addiction treatment","volume":"16","author":"Christian","year":"2021","journal-title":"J Hosp Med"},{"issue":"2","key":"2023112713581581100_b22","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1111\/dar.13394","article-title":"Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: a case series","volume":"41","author":"Shearer","year":"2022","journal-title":"Drug Alcohol Rev"},{"issue":"5","key":"2023112713581581100_b23","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1176\/appi.ps.202000565","article-title":"How physician workforce shortages are hampering the response to the opioid crisis","volume":"73","author":"McNeely","year":"2022","journal-title":"Psychiatr Serv"},{"issue":"6","key":"2023112713581581100_b24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/jhm.12837","article-title":"Implementation of a comprehensive hospitalist-led initiative to improve care for patients with opioid use disorder","volume":"17","author":"Clifton","year":"2022","journal-title":"J Hosp Med"},{"key":"2023112713581581100_b25","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.drugalcdep.2018.06.004","article-title":"Risks of fatal opioid overdose during the first year following nonfatal overdose","volume":"190","author":"Olfson","year":"2018","journal-title":"Drug Alcohol Depend"},{"issue":"3","key":"2023112713581581100_b26","doi-asserted-by":"crossref","first-page":"137","DOI":"10.7326\/M17-3107","article-title":"Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study","volume":"169","author":"Larochelle","year":"2018","journal-title":"Ann Intern Med"}],"container-title":["Hospital Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/13\/2\/e23\/1574496\/hpeds.2022-006864.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article-pdf\/13\/2\/e23\/1574496\/hpeds.2022-006864.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T13:59:13Z","timestamp":1701093553000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/hospitalpediatrics\/article\/13\/2\/e23\/190497\/A-Novel-Inpatient-Buprenorphine-Induction-Program"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,1,23]]},"published-print":{"date-parts":[[2023,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/hpeds.2022-006864","relation":{},"ISSN":["2154-1663","2154-1671"],"issn-type":[{"value":"2154-1663","type":"print"},{"value":"2154-1671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}