ArticleDrug and alcohol review2020
Use of a novel prescribing approach for the treatment of opioid use disorder: Buprenorphine/naloxone micro-dosing - a case series.
Article in Drug and alcohol review, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review.Pharmacotherapy · 2022Pooled it
- Opioid agonist therapy switching among individuals with prescription-type opioid use disorder: Secondary analysis of a pragmatic randomized trial.Drug and alcohol dependence · 2023Trial
- Implementation of low-dose buprenorphine induction at a syringe services program.Addiction science & clinical practice · 2026Article
- Clinical Impact of an Expanded MOUD Access Initiative for Patients Hospitalized With Infections From Intravenous Opioid Use.American journal of medicine open · 2025Article
- Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl.JAMA network open · 2025Article
- Navigating Buprenorphine Therapy: A Closer Look at Microdosing vs. Macrodosing for Pain Management and Opioid Addiction - A Narrative Review.Addiction & health · 2024Review
- Emergency department management of opioid use disorder in pediatric patients.Journal of the American College of Emergency Physicians open · 2024Article
- Withdrawal during outpatient low dose buprenorphine initiation in people who use fentanyl: a retrospective cohort study.Harm reduction journal · 2024Article
- Low dose IV buprenorphine inductions for patients with opioid use disorder and concurrent pain: a retrospective case series.Addiction science & clinical practice · 2023Article
- Interest in using buprenorphine-naloxone among a prospective cohort of street-involved young people in Vancouver, Canada.Journal of substance use and addiction treatment · 2023Article
- A Case Series of Spouses Undergoing Rapid Micro-Induction Technique of Buprenorphine Initiation from Methadone.Kansas journal of medicine · 2023Article
- Current and emerging pharmacotherapies for opioid dependence treatments in adults: a comprehensive update.Expert opinion on pharmacotherapy · 2022Review
- Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: A case series.Drug and alcohol review · 2022Article
- Successful conversion from butorphanol nasal spray to buprenorphine/naloxone using a low-dose regimen to assist with opioid tapering in the setting of chronic pain and migraine management in an older adult patient: A case report.Canadian journal of pain = Revue canadienne de la douleur · 2022Article
- The Pharmacology of Buprenorphine Microinduction for Opioid Use Disorder.Clinical drug investigation · 2021Review
- Microdosing and standard-dosing take-home buprenorphine from the emergency department: A feasibility study.Journal of the American College of Emergency Physicians open · 2020Article
- Balancing transition and readmission: a comparative study of low-dose vs standard buprenorphine initiation for medically managed opioid withdrawal.Journal of addictive diseasesArticle
- The Impact of High-Potency Synthetic Opioids on Pharmacotherapies for Opioid Use Disorder: A Scoping Review.Journal of addiction medicineArticle
- Uptake of Low-dose Buprenorphine Initiation and Associated Patient Characteristics in British Columbia, Canada: A Population-based Cohort Study.Journal of addiction medicineArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
INTRODUCTION AND
aimsBuprenorphine/naloxone is an evidence-based treatment for opioid use disorder, but an identified limitation is the period of required opioid abstinence prior to induction on the medication. 'Micro-dosing', or using incrementally increasing doses of buprenorphine/naloxone over time, may be a way to overcome this challenge as it can be done in parallel with the ongoing use of other opioids (either illicit or prescribed). DESIGN AND
methodsA retrospective case series (January to December 2018) was completed of seven participants who underwent buprenorphine/naloxone induction using micro-dosing at two outpatient addiction clinics in Vancouver, Canada.
resultsSeven participants completed a 7-day buprenorphine/naloxone micro-dosing protocol. Prior to and during the induction, one participant was prescribed methadone, three were prescribed slow release oral morphine and three used only illicit fentanyl. Participants were prescribed sublingual buprenorphine/naloxone: 0.5 mg once daily (day 1), 0.5 mg twice daily (BID; day 2), 1 mg BID (day 3), 2 mg BID (day 4), 3 mg BID (day 5), 4 mg BID (day 6) and 12 mg once daily (day 7). On day 7, all prescribed or illicit full opioid agonists were discontinued. Buprenorphine/naloxone was subsequently titrated to a daily dose of between 12 and 32 mg. All patients reported success with buprenorphine/naloxone induction with no precipitated withdrawal. DISCUSSION AND
conclusionsBuprenorphine/naloxone micro-dosing may offer a promising alternative approach for successful induction for individuals with opioid use disorder who desire treatment with buprenorphine/naloxone, and further research to determine effectiveness is warranted.
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Registered trials
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