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J Pain Palliat Care Pharmacother · Mar 2022
Microinduction to Buprenorphine from Methadone for Chronic Pain: Outpatient Protocol with Case Examples.
- Jasmine SilvaMarcelinaM0000-0002-4020-3449, Zhanette Coffee, Jessica Goza, and Kelly Rumrill.
- J Pain Palliat Care Pharmacother. 2022 Mar 1; 36 (1): 40-48.
AbstractThe negative sequelae of full mu agonist chronic opioid analgesic therapy (COAT) are numerous and well documented. One safer alternative to COAT use in chronic, non-cancer pain (CNCP) is a transition to buprenorphine. However, transitioning patients from methadone COAT regimens can be challenging due to the pharmacodynamics of buprenorphine, as well as to the limited commercial formulations of buprenorphine available, and their restrictive instructions for use. Presented here are clinical cases transitioned to buprenorphine from methadone via a novel microinduction protocol during enrollment in an outpatient, group, integrative, multidisciplinary program. The protocol was successful to promote satisfactory and sustained COAT cessation for patients with CNCP and is arguably safer than current conventional practices.
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