Buprenorphine ‘microdosing’ method for switching patients with opioid dependence from methadone to buprenorphine

Various factors limit the acceptability of methadone as an opioid agonist treatment (OAT), in which case, buprenorphine becomes the preferred alternative. The classical approach is to gradually taper methadone to a low dose and buprenorphine is initiated after some opioid-free period, which generally takes weeks. A novel approach known as 'microdosing' or the 'Bernese method' might serve as a valuable alternative. We describe two cases where the patients were successfully transitioned from methadone to buprenorphine using this method.