24-Hour Induction of Transdermal Buprenorphine to Buprenorphine Extended-Release
Buprenorphine is an effective treatment for opioid use disorder but can be slow when using a standard low-dose titration protocol to avoid precipitated withdrawal. This presents a substantial practical barrier in clinical practice. Recent low-dose induction strategies have attempted to simplify and shorten the process required for successful induction, including our own transdermal buprenorphine method, which achieves induction to sublingual buprenorphine/naloxone after 48 h. Here, we present two inpatients with active unregulated fentanyl use that were successfully initiated on buprenorphine extended-release with a novel 24-h transdermal buprenorphine protocol without precipitating withdrawal. This protocol may represent a substantial improvement in the practical feasibility of initiating buprenorphine for patients and providers, although further study is required to confirm efficacy and tolerability.
Authors
- Jéssica Lígia Picanço Machado (ORCID: https://orcid.org/0000-0003-0870-1090)
- Victor W. Li
- Amer Raheemullah (ORCID: https://orcid.org/0000-0002-4651-634X)
- Sarah E. Wakeman (ORCID: https://orcid.org/0000-0002-5475-2713)
- Martha J. Ignaszewski (ORCID: https://orcid.org/0000-0002-6887-1457)
- Pouya Azar (ORCID: https://orcid.org/0009-0009-8054-6911)
- Julio Montaner (ORCID: https://orcid.org/0000-0002-6201-9829)
- Mohammadali Nikoo (ORCID: https://orcid.org/0000-0002-7692-3923)
- James S.H. Wong (ORCID: https://orcid.org/0000-0003-3030-311X)
- Michael Krausz (ORCID: https://orcid.org/0000-0002-6208-4364)
- Rodney Mullen
- Anil R. Maharaj
- Nickie Mathew
Institutions
- Harvard University (US)
- University of British Columbia (CA)
- Provincial Health Services Authority (CA)
- Vancouver General Hospital (CA)
- Massachusetts General Hospital (US)
- AIDS Vancouver (CA)
- Response Biomedical (Canada) (CA)
- Stanford University (US)
Publication Details
- Journal
- Journal of Psychoactive Drugs
- Published
- 2024-11-19
- DOI
- https://doi.org/10.1080/02791072.2024.2430616
- Citations
- 4
- Primary Topic
- Opioid Use Disorder Treatment
- Type
- article
- Field-Weighted Citation Impact
- 2.17