# Rapid outpatient low-dose initiation of buprenorphine for individuals with OUD using fentanyl

> **NIH NIH R34** · UNIVERSITY OF PENNSYLVANIA · 2024 · $227,250

## Abstract

PROJECT SUMMARY
Opioid use disorder (OUD) involving fentanyl is a major public health problem. OUD treatment with
buprenorphine reduces all-cause mortality and drug-related morbidity and can be started by licensed
prescribers in any outpatient or inpatient setting. For individuals using fentanyl, the process of starting
buprenorphine is increasingly complicated by precipitated withdrawal. Withdrawal during initiation of
buprenorphine deters some individuals from starting treatment and has been associated with treatment drop-
out and relapse among those who do start. The goal of this project is to test the preliminary efficacy, safety,
feasibility, and acceptability of a novel approach to initiating buprenorphine treatment for OUD that can be used
in outpatient setting without requiring or precipitating opioid withdrawal. We will recruit 60 subjects with
untreated OUD and recent fentanyl use through the University of Pennsylvania's Center for the Studies of
Addiction. Subjects will be randomized to one of two arms: standard initiation, in which subjects will start
buprenorphine after >8 hours of abstinence once they develop moderate opioid withdrawal with Clinical Opiate
Withdrawal Scale (COWS) at least 11; or a novel low-dose (“micro-dose”) approach, which is started with
COWS<4 and where buprenorphine doses are escalated over 10 hours, without ongoing use of full-agonist
opioids. We will compare success rates with each approach, with “success” defined as reaching a total-daily
dose of 8 mg buprenorphine without an increase of >6 in COWS from baseline and without early termination
for any reason. Findings from this study will be used to support an R01 application to test this novel approach
to initiating buprenorphine in real-world, outpatient settings with a larger sample of individuals with untreated
OUD. This methodology has broad applications for increasing access to office-based treatment for OUD.

## Key facts

- **NIH application ID:** 10907800
- **Project number:** 5R34DA057507-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** KYLE Matthew KAMPMAN
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $227,250
- **Award type:** 5
- **Project period:** 2023-08-15 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10907800

## Citation

> US National Institutes of Health, RePORTER application 10907800, Rapid outpatient low-dose initiation of buprenorphine for individuals with OUD using fentanyl (5R34DA057507-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10907800. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*