What is a common complication for patients starting buprenorphine treatment who have a history of opioid use?

The correct choice relates to the phenomenon known as opioid withdrawal syndrome, which can occur when a patient with a history of opioid use is initiated on buprenorphine treatment. Buprenorphine acts as a partial agonist at the mu-opioid receptors, meaning it can both activate these receptors and also block them depending on the level of Full agonist opioids present in the system.

If a patient has recently used full agonist opioids and then begins treatment with buprenorphine, the introduction of buprenorphine can displace those opioids from their receptors, leading to withdrawal symptoms. This can be particularly pronounced if buprenorphine is started too soon after the last dose of opioids. This episode of withdrawal is often referred to as "precipitated withdrawal," and it can cause significant discomfort and anxiety for the patient.

Recognizing that this is a potential complication underlines the importance of having a structured induction protocol and assessing the patient's opioid use history to time the initiation of buprenorphine properly. This helps ensure that the patient is not in a state of withdrawal when beginning treatment, which is critical for the efficacy and the overall therapeutic experience of the buprenorphine regimen.