Buprenorphine microdosing regimen using transdermal buprenorphine patches to transition from methadone to buprenorphine
Thileepan Naren, Jon Cook, Paul MacCartney, Dean Membrey
Drug and Alcohol Review May 1, 2024 DOI: 10.1111/dar.13826 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective case series Case report Peer reviewed |
|---|---|
| Sample size | 32 |
| Population | Patients at cohealth Innerspace community clinic undergoing transition from methadone to buprenorphine |
| Intervention | Transdermal buprenorphine patches |
| Dose | fixed-dose transdermal buprenorphine patch regimen |
| Topics | Microdosing |
| Key findings | A fixed-dose transdermal buprenorphine patch regimen enabled 23 of 32 patients to transition from methadone to sublingual or long-acting injectable depot buprenorphine in an outpatient setting, and all patients were retained in treatment regardless of transition success. The authors note the small sample size and call for further research to demonstrate effectiveness. |
Abstract
AbstractIntroductionThis case series records a cohort of patients treated with transdermal buprenorphine patches as part of a buprenorphine microdose induction protocol to transition from methadone to buprenorphine in a community setting. This has historically been a difficult process to manage in community settings and this case series explored a method to gradually manage this in an outpatient setting.MethodA retrospective file audit was conducted of the electronic medical records of cohealth Innerspace patients who had undergone buprenorphine microdose induction using transdermal patches. A total of 32 patients were identified.ResultsIn this case series 23 of the 32 patients successfully transitioned from methadone to sublingual or long‐acting injectable depot buprenorphine preparations utilising the transdermal buprenorphine microdosing technique. All patients in this case series regardless of the success of the transition were retained in treatment.Discussion and ConclusionsA fixed‐dose transdermal buprenorphine patch regimen enabled 23 of 32 patients in this case series transition from methadone to buprenorphine in an outpatient setting. Given the small sample size further research is required to demonstrate the effectiveness of this technique.
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
Cites 2
- Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study Frontiers in Pharmacology March 23, 2021
- Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach Addiction Science & Clinical Practice January 19, 2020