Buprenorphine-naloxone microdosing: Tool for opioid agonist therapy induction

A drawback to traditional initiation of buprenorphine-naloxone is that before induction patients must have abstained from opioids for a minimum of 12 to 36 hours to prevent precipitated withdrawal, which occurs owing to displacement of full opioid agonists from the µ-receptor. This abstention presents a considerable barrier to treatment initiation.1,3 A novel off-label approach known as microdosing or the Bernese method3 might serve as a valuable tool to ease buprenorphine-naloxone induction for both patients and prescribers by circumventing the withdrawal impediment.