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Micro-dosing Intravenous Buprenorphine to Rapidly Transition From Full Opioid Agonists.

Thakrar AP, Jablonski L, Ratner J, Rastegar DA. Micro-dosing Intravenous Buprenorphine to Rapidly Transition From Full Opioid Agonists. Journal of addiction medicine. 2022 Jan 1; 16(1):122-124.

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For patients with opioid use disorder transitioning from methadone or requiring opioid analgesia, initiating buprenorphine for opioid use disorder can be difficult because of the risk of precipitated withdrawal. Low-dose initiation, also known as micro-dosing, is an alternative to standard initiation. Prior studies relied on nonstandard dosing of tablets or films, patches, or buccal formulations, all of which are unavailable in many hospitals. We report a novel approach to micro-dosing using intravenous buprenorphine. Two patients, one on methadone maintenance and another requiring postoperative opioid analgesia, were transitioned to buprenorphine with concurrent full-agonist opioids and without precipitated withdrawal.

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