Rapid Induction of Buprenorphine/Naloxone for Chronic Pain Using a Microdosing Regimen: A Case Report
Danny S. Lee, Jessica E. Hann, Sukhpreet Klaire, Mohammadali Nikoo, Michael D. Negraeff, Pouya Rezazadeh-Azar
A&A Practice January 15, 2020 DOI: 10.1213/xaa.0000000000001138 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 66-year-old woman with inadequately controlled postoperative pain despite escalating doses of oxycodone and methadone |
| Intervention | Buprenorphine/naloxone |
| Topics | Microdosing |
| Key findings | A 66-year-old woman with poorly controlled postoperative pain on escalating oxycodone and methadone was transitioned to buprenorphine/naloxone using a rapid microinduction technique without precipitating opioid withdrawal. The authors propose that rapid induction offers an alternative for transitioning patients from other opioids to buprenorphine/naloxone and may shorten the time needed to switch chronic pain patients to buprenorphine compared with existing protocols. |
Abstract
Buprenorphine is an effective treatment for chronic pain and may reduce opioid-induced hyperalgesia. However, its pharmacological properties make its induction challenging, time-consuming, and can precipitate opioid withdrawal. We present the case of a 66-year-old woman with inadequately controlled postoperative pain despite escalating doses of oxycodone and methadone, who was successfully transitioned to buprenorphine/naloxone using a rapid microinduction technique without precipitating opioid withdrawal. Rapid induction provides an alternative method for transitioning patients from other opioids to buprenorphine/naloxone and facilitates transition of patients with chronic pain to buprenorphine therapy within a shorter window compared to currently existing protocols.
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 4
- Inpatient Transition from Methadone to Buprenorphine–Naloxone Using a Microdosing Strategy in a Postoperative Cancer Patient: A Case Report Journal of Palliative Medicine April 30, 2024
- 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