Azar, Pouya and Schneiderman, Hannah and Barron, Henry and Wong, James S H and Meyer, Maximilian and Newman-Azar, Dayyon and Narimani, Matin and Ignaszewski, Martha J and Mathew, Nickie and Mullen, Rodney and Krausz, Reinhard M and Maharaj, Anil R (2024) Rapid induction of transdermal buprenorphine to subcutaneous extended-release buprenorphine for the treatment of opioid use disorder. Addiction Science & Clinical Practice, 19, 50. https://doi.org/10.1186/s13722-024-00479-1.
External website: https://ascpjournal.biomedcentral.com/articles/10....
BACKGROUND: Buprenorphine is an effective and safe treatment for opioid use disorder, but the requirement for moderate opioid withdrawal symptoms to emerge prior to initiation is a significant treatment barrier.
CASE PRESENTATION: We report on two cases of hospitalized patients with severe, active opioid use disorder, in which we initiated treatment with transdermal buprenorphine over 48 h, followed by the administration of a single dose of sublingual buprenorphine/naloxone and then extended-release subcutaneous buprenorphine. The patients did not experience precipitated withdrawal and only had mild withdrawal symptoms.
CONCLUSIONS: This provides preliminary evidence for a rapid induction strategy that may improve tolerability, caregiver burden, and treatment retention as compared to previous induction strategies.
B Substances > Opioids (opiates) > Opioid product > Buprenorphine / Suboxone
G Health and disease > Substance use disorder (addiction) > Drug use disorder
HJ Treatment or recovery method > Substance disorder treatment method > Substance replacement method (substitution) > Opioid agonist treatment (methadone maintenance / buprenorphine)
HJ Treatment or recovery method > Treatment outcome
J Health care, prevention, harm reduction and treatment > Treatment and maintenance > Treatment factors
VA Geographic area > Canada
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