Buprenorphine Microdose Induction for the Management of Prescription Opioid Dependence

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13 Scopus citations


Prescription opioid dependence remains a major source of morbidity and mortality in the United States. Patients previously on high-dose opioids may poorly tolerate opioid tapers. Current guidelines support the use of buprenorphine therapy in opioid-tapering protocols, even among patients without a diagnosis of opioid use disorder. Buprenorphine microinduction protocols can be used to transition patients to buprenorphine therapy without opioid withdrawal. From November 2019 to April 2020, we transitioned 8 patients on high-dose prescribed opioids for pain to sublingual buprenorphine-naloxone using a microdose protocol without any evidence of precipitated withdrawal. Six of these patients remain on buprenorphine-naloxone and report improved analgesia. Because of its simplicity, the buprenorphine microinduction protocol can be easily adapted for telemedicine and may help to prevent unnecessary clinic visits and opioid-related admissions in the setting of social distancing regulations during the coronavirus 2019 pandemic. ( J Am Board Fam Med 2021;34:S141-S146.) copyright. J Am Board Fam Med: First published as 10.3122/jabfm.2021.S1.200236 on 23 February 2021..

Original languageEnglish (US)
Pages (from-to)S141-S146
JournalJournal of the American Board of Family Medicine
StatePublished - Feb 2021


  • Buprenorphine naloxone
  • Covid-19
  • Opioid addiction
  • Pain
  • Pandemics
  • Telemedicine

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice


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