Jonathan L. Robbins, MD, MS; Honora Englander, MD; Jessica Gregg, MD, PhD
Corresponding Author: Jonathan Robbins, MD, MS; Oregon Health & Science University. Email: robbijon@ohsu.edu
Section: Brief Report
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Prescription opioid dependence remains a major source of morbidity and mortality in the US. 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 – 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. Due to 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.