PT  - JOURNAL ARTICLE
AU  - Robbins, Jonathan L.
AU  - Englander, Honora
AU  - Gregg, Jessica
TI  - Buprenorphine Microdose Induction for the Management of Prescription Opioid Dependence
AID  - 10.3122/jabfm.2021.S1.200236
DP  - 2021 Feb 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - S141--S146
VI  - 34
IP  - Supplement
4099  - http://www.jabfm.org/content/34/Supplement/S141.short
4100  - http://www.jabfm.org/content/34/Supplement/S141.full
SO  - J Am Board Fam Med2021 Feb 01; 34
AB  - Prescription opioid dependence remains a major source of morbidity and mortality in the United States. Patients previously on high-dose opioids may poorly tolerate opioid tapers. Current guidelines support the use of buprenorphine therapy in opioid-tapering protocols, even among patients without a diagnosis of opioid use disorder. Buprenorphine microinduction protocols can be used to transition patients to buprenorphine therapy without opioid withdrawal. From November 2019 to April 2020, we transitioned 8 patients on high-dose prescribed opioids for pain to sublingual buprenorphine-naloxone using a microdose protocol without any evidence of precipitated withdrawal. Six of these patients remain on buprenorphine-naloxone and report improved analgesia. Because of its simplicity, the buprenorphine microinduction protocol can be easily adapted for telemedicine and may help to prevent unnecessary clinic visits and opioid-related admissions in the setting of social distancing regulations during the coronavirus 2019 pandemic.