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Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach Rozylo, Jennifer; Mitchell, Keren; Nikoo, Mohammadali; Durante, S. E.; Barbic, Skye; Lin, Daniel; Mathias, Steve; Azar, Pouya

Abstract

Background: The requirement for moderate withdrawal prior to initiation can be a barrier to buprenorphine/naloxone induction. Case presentation: We aimed to use a microdosing regimen to initiate regular dosing of buprenorphine/naloxone in a high-risk patient with a history of failed initiations due, in part, to withdrawal symptoms. Using an assertive outreach model and a buprenorphine/naloxone microdosing schedule, we initiated treatment of an individual’s opioid use disorder. There was a successful buprenorphine/naloxone microdosing induction as the team reached a therapeutic dose of buprenorphine/naloxone. Including the induction period, the medication was used consistently for 4 weeks. Conclusions: A microdosing schedule can be used to induce a patient onto buprenorphine/naloxone with no apparent withdrawal; gradually reducing illicit substance use. This case report builds on previous literature, highlighting ways to minimize barriers to induction of buprenorphine/naloxone, using a microdosing schedule and assertive outreach. Given the safety profile of buprenorphine and its potential to be a lifesaving intervention, a larger study of microdosing is indicated.

Item Metadata

Title
Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach
Creator
Rozylo, Jennifer; Mitchell, Keren; Nikoo, Mohammadali; Durante, S. E.; Barbic, Skye; Lin, Daniel; Mathias, Steve; Azar, Pouya
Contributor
University of British Columbia. Addictions and Concurrent Disorders Research Group; St. Paul's Hospital (Vancouver, B.C.); Centre for Health Evaluation & Outcome Sciences
Publisher
BioMed Central
Date Issued
2020-01-15
Description
Background: The requirement for moderate withdrawal prior to initiation can be a barrier to buprenorphine/naloxone induction. Case presentation: We aimed to use a microdosing regimen to initiate regular dosing of buprenorphine/naloxone in a high-risk patient with a history of failed initiations due, in part, to withdrawal symptoms. Using an assertive outreach model and a buprenorphine/naloxone microdosing schedule, we initiated treatment of an individual’s opioid use disorder. There was a successful buprenorphine/naloxone microdosing induction as the team reached a therapeutic dose of buprenorphine/naloxone. Including the induction period, the medication was used consistently for 4 weeks. Conclusions: A microdosing schedule can be used to induce a patient onto buprenorphine/naloxone with no apparent withdrawal; gradually reducing illicit substance use. This case report builds on previous literature, highlighting ways to minimize barriers to induction of buprenorphine/naloxone, using a microdosing schedule and assertive outreach. Given the safety profile of buprenorphine and its potential to be a lifesaving intervention, a larger study of microdosing is indicated.
Subject
Opioid use disorder; Buprenorphine/naloxone; Microdosing; Bernese method; Induction method
Genre
Article
Type
Text
Language
eng
Date Available
2020-01-16
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0388312
URI
http://hdl.handle.net/2429/73334
Affiliation
Medicine, Faculty of; Other UBC; Non UBC; Occupational Science and Occupational Therapy, Department of
Citation
Addiction Science & Clinical Practice. 2020 Jan 15;15(1):2
Publisher DOI
10.1186/s13722-020-0177-x
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
Aggregated Source Repository
DSpace

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Rights

Attribution 4.0 International (CC BY 4.0)