Buprenorphine Microdose Induction for the Management of Prescription Opioid Dependence

Journal of the American Board of Family Medicine: JABFM

article

Jonathan L. Robbins¹  Honora Englander¹  Jessica Gregg¹ 

[1] Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health and Science University;Division of Hospital Medicine, Section of Addiction Medicine, Oregon Health and Science University

关键词: Buprenorphine Naloxone;    COVID-19;    Opioid Addiction;    Pain;    Pandemics;    Telemedicine;   

DOI  :  10.3122/jabfm.2021.S1.200236

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

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.

【 授权许可】

CC BY