Sickle cell acute pain crisis increase in frequency with age, and some patients develop chronic pain. Currently there are guidelines for management of acute pain crisis, but not for chronic pain. Chronic pain management defaults to long-term opioid therapy. Buprenorphine is a partial opioid agonist, a potent analgesic, with a respiratory ceiling effect. It may provide analgesic benefit and a ‘harms reduction approach’ in the management of chronic pain in pediatric patients with sickle cell disease. Buprenorphine is increasingly used in adult patients with sickle cell disease. We describe the inpatient micro-induction protocol we implemented in our pediatric center.