Opioid Withdrawal Treatment: Buprenorphine/Naloxone (Suboxone)

Clinical Pathways promote evidence-based, safe, and high-value patient care by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by a methodical review of available evidence and consensus among committee members. 

 Clinical Pathway: 

• Opioid Withdrawal Treatment: Buprenorphine/Naloxone (Suboxone) Algorithm  
• Opioid Withdrawal Treatment: Buprenorphine/Naloxone (Suboxone) Clinical Pathway Synopsis (provides care standards employed for this clinical pathway) 

 Additional tools associated with this Clinical Pathway: 

• Opioid Stewardship Program Resources (available to Children’s Mercy providers) 
• Naloxone handout – English and Spanish 
• Suboxone Sublingual Films handout – English and Spanish 
• Suboxone Sublingual Films handout (printable version) – English and Spanish
• How to Talk to Your Kids About Using Drugs – English and Spanish 
• Important Facts to Know When Taking Opioids – English and Spanish 
• Illicit Fentanyl handout – English and Spanish 

 Inclusion and exclusion criteria: 

• Inclusion: 
  • Patient presenting with suspected opioid withdrawal or potential opioid use disorder  
• Exclusion:  
  • Patient < 12 years of age 
  • Patient being actively weaned 
  • Patient with sickle cell disease 
  • Patient on chronic therapeutic opioids 

 Committee members involved in the development: 

• Michelle DePhillips, MD | Pediatric Emergency Medicine | Committee Co-Chair  
• Michael Christian, MD | Clinical Pharmacology and Toxicology | Committee Co-Chair  
• Adam Algren, MD | Clinical Pharmacology and Toxicology | Committee Member  
• Liz Edmundson, PhD, RN, NE-BC | Patient Care Services, Program Manager, Comfort Promise and Opioid Stewardship | Committee Member  
• Jonathan Ermer, MD | Pediatric Hospital Medicine Fellow | Committee Member  
• Giang Nguyen, MD, FAAP | Hospital Medicine | Committee Member  
• Sara Anderson, MD, MPH | Developmental and Behavioral Health | Committee Member  
• Ryan Hodges Pasternak, MD, MPH | Adolescent Medicine | Committee Member  
• Ellen Bryant, MD | Pediatric Adolescent Medicine Fellow | Committee Member  
• Justin Chu, MD | Pediatric Resident | Committee Member  
• Rebecca Eck, MSN, APRN, FNP-C, CPN | Urgent Care | Committee Member  
• Sarah Lee, LCSW, LSCSW | Social Work | Committee Member  
• Ibad Siddiqi, PharmD | Pharmacy | Committee Member  
• Sarah Dierking, MSN, RN, CPHQ | Clinical Practice and Quality | Committee Member 

 Patient/Family Committee Member: 

• Kasi Trader | Committee Member  

 EBP Committee Members: 

• Todd Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice  
• Kelli Ott, OTD, OTR/L | Evidence Based Practice  

Publication dates: 

• Finalized date:  9/2025
• Next expected revision date:  9/2028

 Concerns with content: 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.