Buprenorphine for Analgesia in Older Adults With Acute Fractures in the Emergency Department

Inclusion Criteria: * Age 65 years or older * Emergency Department patient * Diagnosis of suspected or confirmed acute fracture * Numerical Rating Scale 4 or greater at time of presentation * Must be able to give informed consent or have a surrogate decisionmaker to provide informed consent * Subjects who may require a surgical procedure are eligible for enrollment, as given the low dose of buprenorphine, this is not anticipated to affect future anesthesia. If additional pain control is needed for surgical procedure, full agonist opioid can be used without contraindication. Exclusion Criteria: * Prior history of opioid use disorder * Participants taking chronic opioid therapy (defined as opioids taken during the past month) * Allergy to study medications * Hemodynamic instability requiring immediate resuscitation * Inability to consent and absence of surrogate decisionmaker