High-dose induction of buprenorphine-naloxone (Suboxone) is available for CPOE activated sites as of March 5, 2025 and will be available at non-CPOE activated sites soon.
Use of high dose inductions aims for quicker saturation of mu-opioid receptors in order to optimize buprenorphine’s partial agonist effects and reduce opioid withdrawal symptoms. This induction method is suitable for patients who have undergone a full opioid reversal with naloxone in the past two hours (without receiving opioids since the reversal), or for patients with high opioid tolerance who would typically receive a traditional induction.
Need help choosing an appropriate buprenorphine induction method? Check out our decision support tool. All three induction methods will be available as an order set later this year at Island Health hospitals.
For quick reference guides on buprenorphine, precipitated withdrawal, and induction methods, visit the Addiction Medicine and Substance Use Clinical Practice Supports page.
For addiction medicine consultation support for high-dose induction of buprenorphine-naloxone (Suboxone), contact:
- Local Addiction Medicine Consult Service provider
- BC Centre on Substance Use 24/7 line (if after AMCS hours): 778-945-7619
For further details, see the Physician Practice Alert: High Dose Induction for OUD.
For education requests or questions, email amsu@islandhealth.ca.