Use of a novel prescribing approach for the treatment of opioid use disorder: Buprenorphine/naloxone micro-dosing - a case series.

摘要: Introduction and aims Buprenorphine/naloxone is an evidence-based treatment for opioid use disorder, but identified limitation the period of required abstinence prior to induction on medication. 'Micro-dosing', or using incrementally increasing doses buprenorphine/naloxone over time, may be a way overcome this challenge as it can done in parallel with ongoing other opioids (either illicit prescribed). Design methods A retrospective case series (January December 2018) was completed seven participants who underwent micro-dosing at two outpatient addiction clinics Vancouver, Canada. Results Seven 7-day protocol. Prior during induction, one participant prescribed methadone, three were slow release oral morphine used only fentanyl. Participants sublingual buprenorphine/naloxone: 0.5 mg once daily (day 1), twice (BID; day 2), 1 BID 3), 2 4), 3 5), 4 6) 12 7). On 7, all full agonists discontinued. subsequently titrated dose between 32 mg. All patients reported success no precipitated withdrawal. Discussion conclusions offer promising alternative approach successful individuals disorder desire buprenorphine/naloxone, further research determine effectiveness warranted.