TY - JOUR
KW - Case Report
KW - buprenorphine
KW - Fentanyl
KW - Methadone
KW - microinduction
AU - S. Kaliamurthy
AU - O. Jegede
AU - G. Hermes
A1 - 
AB - INTRODUCTION: The micro-induction method of initiating buprenorphine is becoming a popular method for initiating buprenorphine in patients with Opioid Use Disorder, who are on full opioid agonists, either prescribed or non-prescribed, in order to avoid precipitated withdrawal. Given the rising concerns around illicit fentanyl use, this method of initiating buprenorphine has become another tool for clinicians to help patients with Opioid Use Disorder, even when multiple full opioid agonists are involved. While the process for initiating buprenorphine through this process is well studied, the characteristics of patients who are able to tolerate this initiation method in an outpatient setting is not. CASE(S): We present the cases of two patients with Opioid Use Disorder in a community-based methadone maintenance program in whom micro-induction methods were used to initiate buprenorphine without lowering the methadone dose. Both patients successfully transitioned to buprenorphine without precipitated withdrawal. One of the patients was also using fentanyl at the time of induction and was able to abstain from fentanyl use following the induction process. CONCLUSION: Initiating Buprenorphine using micro-induction strategies in a community based outpatient clinic in patients who are already on full opioid agonists is feasible, in these particular cases, the methadone dose or concurrent fentanyl use did not affect the outcome. We present the characteristics of the patient and the community clinic hoping that this helps more clinicians in replicating this induction strategy.
AD - Department of Psychiatry, Yale University School of Medicine; APT Foundation, New Haven, CT, USA.; Department of Psychiatry, Yale University School of Medicine; APT Foundation, New Haven, CT, USA.; Department of Psychiatry, Yale University School of Medicine; APT Foundation, New Haven, CT, USA.; Yale Stress Center, New Haven, CT, USA.
BT - Journal of addictive diseases
C5 - Opioids & Substance Use
CY - England
DO - 10.1080/10550887.2022.2051985
JF - Journal of addictive diseases
LA - eng
M1 - Journal Article
N2 - INTRODUCTION: The micro-induction method of initiating buprenorphine is becoming a popular method for initiating buprenorphine in patients with Opioid Use Disorder, who are on full opioid agonists, either prescribed or non-prescribed, in order to avoid precipitated withdrawal. Given the rising concerns around illicit fentanyl use, this method of initiating buprenorphine has become another tool for clinicians to help patients with Opioid Use Disorder, even when multiple full opioid agonists are involved. While the process for initiating buprenorphine through this process is well studied, the characteristics of patients who are able to tolerate this initiation method in an outpatient setting is not. CASE(S): We present the cases of two patients with Opioid Use Disorder in a community-based methadone maintenance program in whom micro-induction methods were used to initiate buprenorphine without lowering the methadone dose. Both patients successfully transitioned to buprenorphine without precipitated withdrawal. One of the patients was also using fentanyl at the time of induction and was able to abstain from fentanyl use following the induction process. CONCLUSION: Initiating Buprenorphine using micro-induction strategies in a community based outpatient clinic in patients who are already on full opioid agonists is feasible, in these particular cases, the methadone dose or concurrent fentanyl use did not affect the outcome. We present the characteristics of the patient and the community clinic hoping that this helps more clinicians in replicating this induction strategy.
PP - England
PY - 2022
SN - 1545-0848; 1055-0887
SP - 1
EP - 6
EP - 
T1 - Community based buprenorphine micro-induction in the context of methadone maintenance treatment and fentanyl - Case report
T2 - Journal of addictive diseases
TI - Community based buprenorphine micro-induction in the context of methadone maintenance treatment and fentanyl - Case report
U1 - Opioids & Substance Use
U2 - 35377273
U3 - 10.1080/10550887.2022.2051985
VO - 1545-0848; 1055-0887
Y1 - 2022
Y2 - Apr 4
ER -