Microinduction of Buprenorphine/Naloxone: A Review of the Literature.

摘要: Background and objectives Buprenorphine's high-binding affinity as a partial µ-opioid agonist displaces preexisting full agonists causing precipitated withdrawal, which requires most individuals starting buprenorphine to endure moderate withdrawal prior induction avoid withdrawal. A novel approach called microinduction has emerged remove this prerequisite. Our aim is review the literature on these alternative approaches. Methods Using keywords including buprenorphine, buprenorphine/naloxone, transdermal suboxone, microinduction, microdosing, rapid induction, buprenorphine-dosing protocol, authors searched PubMed/Medline, EMBASE, PsycINFO, PsychARTICLES, Scopus databases from date of inception through April 30, 2020, yielded 1726 results, which, in turn, after manual exclusion for irrelevant content publication languages other than English, generated total 18 papers. Results On basis papers included review, 63 patients were successfully transitioned using different microdosing techniques, primarily inpatient setting. From available data, variety opioids over range dosing without significant initial doses ranged frequently 0.2 0.5 mg. While timeframe various schedules 3 112 days, period 4 8 participants completed cross titration at 16 Discussion conclusions The growing demonstrates some promise models, specifically targeting averse prescribed chronic pain, high-dose methadone, illicit or pharmaceutical fentanyl. Scientific significance This manuscript provides existing help clinicians better understand approaches clinical settings populations. (Am J Addict 2020;00:00-00).