ArticleJournal of addiction medicine
Successful Buprenorphine/Naloxone Low-dose Induction in Pregnancy: A Case Report.
Article in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 16 citations in OpenAlex.
- Buprenorphine Microinduction Treatment in Tri-Diagnosis Patients with Opioid Use Disorder and Chronic Non-Cancerous Pain.Current pain and headache reports · 2026Review
- An Alternative Approach to Low-Dose Buprenorphine Induction in Pregnancy and Postpartum.O&G open · 2024Article
- Withdrawal during outpatient low dose buprenorphine initiation in people who use fentanyl: a retrospective cohort study.Harm reduction journal · 2024Article
- Low-dose buprenorphine initiation during pregnancy: a case report.AJOG global reports · 2024Article
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
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Abstract
backgroundMedication for opioid use disorder (OUD) with methadone or buprenorphine/naloxone is recommended for pregnant women with OUD. Traditional buprenorphine/naloxone induction requires patients to be in moderate withdrawal before the first dose of medication to minimize the chances of precipitated withdrawal. The low-dose buprenorphine "microinduction" (Bernese) method was described in 2016 and involves giving small doses of buprenorphine to patients for whom opioid withdrawal was not desirable. This method is being used widely in Vancouver in the context of high rates of overdose due to fentanyl poisoning. CASE PRESENTATION: A 24-year-old woman, in her first pregnancy, with severe opioid and stimulant use disorder successfully started on buprenorphine/naloxone through a low-dose-induction protocol. The dose was started at 0.5 mg sublingual daily and slowly increased to 18 mg over 17 days. She continued to use fentanyl/heroin during the induction. She did not experience precipitated withdrawal and was able to stop using nonprescribed opioids once at a therapeutic dose of buprenorphine/naloxone. DISCUSSION: This represents the first documented case of successful buprenorphine/naloxone low-dose induction in pregnancy. First-line recommendations still remain to use traditional buprenorphine/naloxone induction when patients present in withdrawal. Obtaining informed consent regarding the lack of research on low-dose induction in pregnancy as well as discussion of risks and benefits is essential.
conclusionLow-dose induction with buprenorphine/naloxone was successfully done in an outpatient setting. This represents a novel way of initiation of medication for OUD, which may enhance choice and collaboration between health care providers and women impacted by substance use in pregnancy.
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