Navigating Buprenorphine Therapy: A Closer Look at Microdosing vs. Macrodosing for Pain Management and Opioid Addiction - A Narrative Review.
Zachary I Merhavy, Marcos Flores, Eliu Rivera, Jordanne Gizzarelli, Samir Ruxmohan, Jonathan Quinonez
Addiction and Health October 1, 2024 DOI: 10.34172/ahj.1590 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Microdosing Addiction |
| Keywords | Buprenorphine therapy Macrodosing Opioid addiction Pain management |
| Key findings | Microdosing and macrodosing of buprenorphine each have distinct benefits and risks, and therapy should be individualized. |
Abstract
Buprenorphine therapy has emerged as a primary therapy method for both opioid addiction and chronic pain; however, the «one size fits all» approach to buprenorphine administration is no longer tenable. This review analyzes the pharmacology of both dosing approaches and their clinical outcomes, safety profiles, and societal implications, providing valuable insights for healthcare professionals. Multiple databases were used in conjunction with a set of inclusion and exclusion criteria to source articles to assess the consensus of best methods for treating opioid use disorder (OUD). This comprehensive review discusses two distinct dosing strategies, microdosing and macrodosing, through a detailed literature search to assess the differences and similarities of each strategy. Microdosing entails administering minimal buprenorphine doses, with promise in pain alleviation and addiction management while mitigating the risks of dependence and side effects typically associated with traditional opioids. In contrast, macrodosing employs higher buprenorphine doses, which is well-established for OUD and chronic pain management but raises concerns concerning misuse and overdose. Tailoring buprenorphine therapy to patients' individual needs is essential in the face of contemporary healthcare challenges related to pain management and opioid addiction.
Comparable studies
Other narrative reviews on microdosing, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Big physics, small doses: the use of AMS and PET in human microdosing of development drugs | 2003 | Review | |
| Phase 0/microdosing approaches: time for mainstream application in drug development? | 2020 | Review | |
| Microdosing and drug development: past, present and future | 2013 | Review | |
| Microdosing and Other Phase 0 Clinical Trials: Facilitating Translation in Drug Development | 2016 | Review | |
| Expectancy Effects in Psychedelic Trials. | 2024 | Review |