Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach
Jennifer Rozylo, Keren Mitchell, Mohammadali Nikoo, S. Elise Durante, Skye P. Barbic, Daniel Lin, Steve Mathias, Pouya Azar
Addiction Science & Clinical Practice January 19, 2020 DOI: 10.1186/s13722-020-0177-x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | High-risk patient with opioid use disorder and history of failed buprenorphine/naloxone inductions |
| Intervention | Buprenorphine/naloxone microdosing |
| Duration | 4 weeks including induction period |
| Topics | Addiction Microdosing |
| Keywords | Buprenorphine/naloxone Bernese method Induction method |
| Key findings | A microdosing schedule enabled successful buprenorphine/naloxone induction without apparent withdrawal in a patient who had previously failed induction. |
Abstract
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.
Comparable studies
Other case reports and case series on microdosing, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Microdosing psilocybin for chronic pain: a case series Individuals with chronic neuropathic pain | 2022 | Case series | n = 3 |
| Microdosing of Psychoactive Substances in Business Practice Business managers and creative professionals | 2021 | Case study | |
| Treatment of neuropathic pain with repeated low-dose MDMA: a case report. 64-year-old male with neuropathic pain after chemotherapy and traumatic life experiences | 2025 | Case study | n = 1 |
| Psycholytic dosing or 'microdosing' of Amanita muscaria (red fly agaric) mushrooms—A retrospective case study A woman in her early thirties with depression, anxiety, and sleep disorders from... | 2023 | Case study | n = 1 |
| Clinical improvement following an integrative iboga microdosing protocol in post-concussive and hypoxic brain injury syndromes: a case series Three individuals with persistent neurologic symptoms after traumatic brain injury or... | 2026 | Case series | n = 3 |
Citations in the library
Cited by 6
- Buprenorphine microdosing regimen using transdermal buprenorphine patches to transition from methadone to buprenorphine Drug and Alcohol Review May 1, 2024
- Transitioning From High-dose Methadone to Buprenorphine Using a Microdosing Approach: Unique Considerations at ASAM Level 3 Facilities Journal of Addiction Medicine March 1, 2023
- Legal Limitations Associated with Microdosing Buprenorphine. Substance Use & Misuse 2023
- Factors that distinguish opioid withdrawal during induction with buprenorphine microdosing: a configurational analysis Addiction Science & Clinical Practice October 4, 2022
- Buprenorphine Microdosing for the Pain and Palliative Care Clinician Journal of Palliative Medicine December 20, 2021
and 1 more in the library