Using Buprenorphine for Pain and Dyspnea in Frail and Older Adults

As the population of older adults with complex medical needs continues to grow, clinicians need clear, practical guidance to manage pain safely and effectively. This two-hour, live, interactive workshop is designed for prescribing clinicians (MDs, PAs, APRNs) and registered nurses (RNs) who care for older adults with serious illness and requiring buprenorphine for pain or dyspnea.

Pain management in this population must account for age-related pharmacokinetics as well as complex medical issues. Buprenorphine, a unique opioid with partial mu agonist and kappa antagonist properties, offers a promising option for pain management in adults who are older and/or frail. This workshop will explore the physiological changes associated with aging that influence opioid selection, examine the pharmacologic properties of buprenorphine, and review current evidence supporting its use in frail and older adults.

Using a case-based approach, participants will receive evidence-based guidance on opioid selection, dosing strategies, and safe prescribing practices. The workshop will also address management of acute pain in patients already on buprenorphine and review the emerging role of buprenorphine in the treatment of dyspnea—a particularly relevant symptom in this population. The workshop will conclude with an open question-and-answer session, allowing clinicians to ask questions, discuss challenging cases, and share clinical experiences related to buprenorphine use in the care of frail and older adults.

Learning Outcomes:

By the end of this workshop, participants will be able to:

1. Describe the pharmacologic properties and mechanism of action of buprenorphine, including its role as both a partial mu agonist and kappa antagonist
2. Discuss the current evidence base supporting the use of buprenorphine for pain management in frail or older adults
3. State three physiological changes in older adults that may affect opioid selection and anticipated response
4. State safe prescribing principles of buprenorphine in older adults, including opioid rotation from another opioid to buprenorphine
5. Explain how to manage an individual’s acute pain while they are on buprenorphine
6. Discuss the use of buprenorphine for the treatment of dyspnea
7. Explain why buprenorphine might be an attractive option for pain management in an older adult or an adult with frailty

This activity has been submitted to the Connecticut Nurses' Association for approval to award contact hours. The Connecticut Nurses' Association is accredited as an approver of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

CAPC is working closely with our educational partners to provide interprofessional continuing education credits.