• Jonathan L Robbins, Honora Englander, and Jessica Gregg.
• From the Assistant Professor, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR; Associate Professor, Division of Hospital Medicine, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR; and Associate Professor, Division of General Internal Medicine and Geriatrics, Section of Addiction Medicine, Oregon Health and Science University, Portland, OR. robbijon@ohsu.edu.
• J Am Board Fam Med. 2021 Feb 1; 34 (Suppl): S141-S146.

AbstractPrescription opioid dependence remains a major source of morbidity and mortality in the United States. 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 to 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. Because of 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.© Copyright 2021 by the American Board of Family Medicine.

25 keywords...

hide…