ReviewClinical drug investigation2021
The Pharmacology of Buprenorphine Microinduction for Opioid Use Disorder.
Review in Clinical drug investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: an updated systematic review.Addiction science & clinical practice · 2025Pooled it
- Factors that distinguish opioid withdrawal during induction with buprenorphine microdosing: a configurational analysis.Addiction science & clinical practice · 2022Pooled it
- Opioid-induced analgesia among persons with opioid use disorder receiving methadone or buprenorphine: A systematic review of experimental pain studies.Drug and alcohol dependence · 2021Pooled it
- Inpatient Low-dose Transitions From Full Agonist Opioids Including Methadone Onto Long-acting Depot Buprenorphine: Case Series From a Multicenter Clinical Trial.Journal of addiction medicineTrial
- "It's like scratching at the door": Experiences of outpatient buprenorphine low dose initiation among people using fentanyl.Journal of substance use and addiction treatment · 2026Article
- Buprenorphine Microinduction Treatment in Tri-Diagnosis Patients with Opioid Use Disorder and Chronic Non-Cancerous Pain.Current pain and headache reports · 2026Review
- 24-48 h initiation by transdermal buprenorphine for the treatment of opioid use disorder in the inpatient setting: a retrospective chart review.Addiction science & clinical practice · 2026Article
- The Buprenorphine Paradox: How Buprenorphine Triggers and Resolves Opioid Withdrawal.Addiction biology · 2026Article
- MiBUP: A pilot randomized controlled trial of low-dose initiation of buprenorphine for opioid use disorder: Design and rationale.Contemporary clinical trials communications · 2026Article
- Outpatient initiation of direct-to-inject buprenorphine.Drug and alcohol dependence · 2026Article
- Outpatient Initiation of 7-Day Injectable Buprenorphine: A Direct-to-Inject Case Series.Substance use & addiction journal · 2025Article
- Fentanyl Polysubstance Use Patterns and Their Associations With Hepatitis C Virus, Skin and Soft Tissue Infections, and Non-Fatal Overdose Among People Who Inject Drugs in New York City.Drug and alcohol review · 2025Article
- Article
- Barriers to Buprenorphine Treatment Among People Experiencing Homelessness: A Qualitative Study from the Provider Perspective.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Lessons from the National institutes of health innovation corps program: defining barriers to developing and commercializing novel solutions for persons with opioid use disorder.Addiction science & clinical practice · 2025Article
- Buprenorphine Pharmacodynamics: A Bridge to Understanding Buprenorphine Clinical Benefits.Drugs · 2025Review
- Outpatient Low-Dose Initiation of Buprenorphine for People Using Fentanyl.JAMA network open · 2025Article
- Illicit Fentanyl Use and Hepatitis C Virus Seroconversion Among People Who Inject Drugs in Tijuana and San Diego: Results From a Binational Cohort Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Emergency department management of opioid use disorder in pediatric patients.Journal of the American College of Emergency Physicians open · 2024Article
- Navigating Buprenorphine Therapy: A Closer Look at Microdosing vs. Macrodosing for Pain Management and Opioid Addiction - A Narrative Review.Addiction & health · 2024Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Although expanding the availability of buprenorphine-a first-line pharmacotherapy for opioid-use disorder (OUD)-has increased the capacity of healthcare systems to offer treatment, starting this medication is fraught with significant barriers. Standard induction regimens require persons with OUD to taper and discontinue full opioid agonists and experience opioid withdrawal prior to the first dose of buprenorphine. Further, emerging evidence indicates that precipitated withdrawal during induction may impact long-term treatment outcomes. Microinduction is a novel approach that, by harnessing buprenorphine's unique pharmacological profile, may allow circumventing the needed for prolonged opioid tapers, and reduce the risk of precipitated withdrawal-holding promise to enhance treatment access. In this review, we examine the pharmacological basis for microinduction and appraise the evidence of this approach to improve clinical outcomes among persons with OUD. First, we highlight the potential dose-dependent effects of buprenorphine on two key neuroadaptations at the mu-opioid receptor (MOR)-resensitization and upregulation. We then focus on how microinduction may reverse these chronic MOR neuroadaptations, allowing the maintenance of an adequate opioid tone, and thereby potentially circumventing opioid withdrawal. Second, we describe the clinical evidence available, derived from observational reports and open-label studies, examining the potential efficacy of microinduction. Despite significant heterogeneity-exemplified by variable buprenorphine formulations, daily doses, and schedules of administration-these data provide preliminary support for the feasibility of microinduction. Finally, we provide new mechanistic, methodological, and clinical insights to guide future translational research, as well as randomized, placebo-controlled clinical trials in this compelling agenda of pharmacotherapy development.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.