Buprenorphine Microdose Induction for the Management of Prescription Opioid Dependence.

Jonathan L Robbins, Honora Englander, Jessica Gregg

Journal of the American Board of Family Medicine : JABFM 2021 Feb

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Prescription opioid dependence remains a major source of morbidity and mortality in the United States. Patients previously on high-dose opioids may poorly tolerate opioid tapers. Current guidelines support the use of buprenorphine therapy in opioid-tapering protocols, even among patients without a diagnosis of opioid use disorder. Buprenorphine microinduction protocols can be used to transition patients to buprenorphine therapy without opioid withdrawal. From November 2019 to April 2020, we transitioned 8 patients on high-dose prescribed opioids for pain to sublingual buprenorphine-naloxone using a microdose protocol without any evidence of precipitated withdrawal. Six of these patients remain on buprenorphine-naloxone and report improved analgesia. Because of its simplicity, the buprenorphine microinduction protocol can be easily adapted for telemedicine and may help to prevent unnecessary clinic visits and opioid-related admissions in the setting of social distancing regulations during the coronavirus 2019 pandemic. © Copyright 2021 by the American Board of Family Medicine.

Citation

Jonathan L Robbins, Honora Englander, Jessica Gregg. Buprenorphine Microdose Induction for the Management of Prescription Opioid Dependence. Journal of the American Board of Family Medicine : JABFM. 2021 Feb;34(Suppl):S141-S146