Listen folks, we’re doing something big here, something really big. AJHP, they’re moving fast, they’re putting manuscripts online as soon as they’re accepted. Peer-reviewed, copyedited, all that good stuff. But remember, these aren’t the final versions. They’ll be replaced with the final, polished articles later.

Now, let’s talk about something important, something really important – prescribing buprenorphine for opioid use disorder (OUD) in the ICU. It’s a tough job, folks, especially with the limited evidence we have. But we’re doing it, we’re making it happen.

Buprenorphine, it’s a partial mu-opioid receptor agonist. It’s going to be used more and more in the ICU because of relaxed regulations. But it’s complicated, folks. Different formulations, different administration routes. There’s no one-size-fits-all dosing strategy. Some people go low-dose, some go high.

Now, if a patient comes into the ICU already on opioids, they won’t feel any pain relief until their baseline opioid needs are met. If they’re not on buprenorphine but might have OUD, it’s tough to diagnose. We don’t have the tools for it, not for critically ill patients.

When we prescribe buprenorphine in the ICU, we have to think about dosing, monitoring, pain management, adjunctive medications, transitioning to outpatient therapy. It’s a lot, folks. Ideally, we’d have addiction and pain management specialists on hand.

Prescribing buprenorphine for OUD in the ICU, it’s a challenge. Whether the patient was already on buprenorphine or is being considered for it, it’s tough. We need more research, folks. We need to know more. But we’re doing it, we’re making it happen. And it’s going to be big, folks. Really big.