Demographics and Clinical Features of Patients Who Underwent Sublingual Buprenorphine Microdose Induction from November 2019 to April 2020
| Patient | Age (y) | Gender | Full Agonist Opioid at Time of Induction | MEDD (mg) | Substance Use Disorder (by DSM-V) | Psychological/Medical Comorbidity | Pain Generators | Maintenance SL Buprenorphine Dosage at 30 days |
|---|---|---|---|---|---|---|---|---|
| 1 | 53 | Female | Fentanyl 100 μg | 240 | None | Rheumatoid arthritis; paroxysmal atrial fibrillation, major depressive disorder | Rheumatoid arthritis | 4 mg – 8 mg – 8 mg |
| 2 | 67 | Male | Hydrocodone/acetaminophen 10–325 mg 8 per day | 80 | None | None | Shoulder, knee, cervical, lumbar osteoarthritis | Not applicable; unable to tolerate buprenorphine 2 mg due to oversedation; back on full agonist at previous dose |
| 3 | 69 | Male | Oxycodone 30 mg 5 times per day | 225 | Benzodiazepine use disorder, mild | Major depressive disorder, hypogonadism, paroxysmal atrial fibrillation | Failed back surgery syndrome | 8 mg 3 times daily and continues on oxycodone 15 mg 3 times daily on slow taper |
| 4 | 62 | Female | Oxycodone 10 mg 5 times per day | 75 | Alcohol use disorder, moderate | Bipolar 2 disorder | Chronic pancreatitis, chronic abdominal pain | Not applicable; unable to tolerate buprenorphine due to nausea; switched back to full agonist, slowly tapering |
| 5 | 63 | Female | Methadone 10 mg twice daily; hydromorphone 2 mg 4 times daily | 92 | Opioid use disorder, mild | Major depressive disorder, adrenal insufficiency, benzodiazepine dependence | Fibromyalgia, knee osteoarthritis | 4 mg 4 times daily |
| 6 | 67 | Male | Hydromorphone 4 mg 5 times daily; morphine extended release 15 mg daily | 95 | Opioid use disorder, mild | Parkinson’s disease, severe odynophagia | Multiple orthopedic surgeries, Parkinson’s disease | 8 mg 3 times daily |
| 7 | 70 | Female | Morphine extended release 30 mg twice daily; morphine immediate release 15 mg 3 times daily | 105 | None | Major depressive disorder | Neuropathy, fibromyalgia, knee osteoarthritis | 8 mg 3 times daily |
| 8 | 53 | Male | Oxycodone 10 mg 7 times daily | 105 | None | Ischemic heart failure, uncontrolled type 2 diabetes mellitus | Chronic leg wounds, lumbar spine osteoarthritis | 8 mg twice daily |
DSM-5, Diagnostic and Statistical Manual of Mental Disorders, fifth edition; MEDD, morphine equivalent daily dose.