Using Microdosing to Induct Patients Into a Long-Acting Injectable Buprenorphine Depot Medication in Low Threshold Community Settings: A Case Study
Joseph Tay Wee Teck, Alexander Baldacchino, Lauren Gibson, Con Lafferty
Frontiers in Pharmacology March 23, 2021 DOI: 10.3389/fphar.2021.631784 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 5 |
| Population | Five patients with opioid use disorder in Scotland, including patients on high-dose methadone treatment |
| Interventions | Buprenorphine Buprenorphine microdosing Injectable long-acting buprenorphine depot Methadone |
| Topics | Microdosing |
| Key findings | The authors present five patients with opioid use disorder who were inducted onto oral buprenorphine using a microdosing regimen and then rapidly transitioned to injectable long-acting buprenorphine depot. They argue that buprenorphine microdosing can make induction to long-acting buprenorphine depot feasible for a broader range of patients, including those on high-dose methadone. |
Abstract
Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlights the valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime.
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 2
Cites 2
- Microdosing and standard‐dosing take‐home buprenorphine from the emergency department: A feasibility study Journal of the American College of Emergency Physicians Open October 20, 2020
- Case report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach Addiction Science & Clinical Practice January 19, 2020