Successful rotation from long-acting full agonist opioids to sublingual buprenorphine/naloxone using a microdosing approach.
René C Vytialingam, Stephan A Schug, Richard O'Regan
Journal of opioid management 2021 DOI: 10.5055/jom.2021.0653 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Adults with opioid use disorder admitted to an inpatient withdrawal unit |
| Topics | Microdosing |
| Key findings | In two cases, microdosing buprenorphine/naloxone successfully induced treatment without precipitated withdrawal and without requiring prior cessation of other opioids. The authors suggest this approach can reduce barriers and complications associated with conventional treatment initiation. |
Abstract
Buprenorphine/naloxone (BPN/NX) is a first-line treatment for opioid use disorder. Conventional treatment guidelines recommend a period of opioid abstinence and the presence of moderate withdrawal before initiation to avoid precipitated withdrawal. A newer approach of "microdosing" removes this requirement and has potential benefits. We present two cases of successful induction of BPN/NX using a microdosing regimen in an inpatient withdrawal unit. Both cases did not result in precipitated withdrawal and did not necessitate prior cessation of other opioids. This case report highlights how the use of microdosing to induct BPN/NX treatment can reduce potential barriers and complications with treatment initiation.
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 |