Buprenorphine Use in Palliative Care.

Palliative care is encountering an increasing number of patients with opioid use disorder who are managed on medication-assisted treatment. Buprenorphine is US Food and Drug Administration approved for office-based management of opioid use disorder. As a partial opioid agonist, it can be used to manage pain in the palliative care setting but can also pose inherent challenges to the management of pain that necessitates full opioid agonists. This article uses a case example to highlight the management of substance use disorder and pain in a patient on buprenorphine along the full illness trajectory. In addition, an overview of buprenorphine pharmacology, unique aspects of the prescribing waiver, and pain management will be discussed.