Outpatient Microdose Induction with Transdermal Buprenorphine: A Case Series

Area of Science:

• Pharmacology
• Addiction Medicine
• Clinical Research

Background:

• Transdermal buprenorphine is FDA-approved for chronic pain.
• Existing research on buprenorphine transitions often focuses on pain patients or inpatient settings.
• Limited data exists for transitioning patients with opioid use disorder (OUD) from methadone and illicit opioids in outpatient settings.

Observation:

• A case series examined seven patients in an outpatient OUD program undergoing transition from methadone and illicit heroin to sublingual buprenorphine using a transdermal buprenorphine protocol.
• All participants were concurrently prescribed methadone and using illicit heroin before and during the transition period.

Findings:

• The transdermal buprenorphine protocol successfully transitioned 5 out of 7 patients (71.4%) to sublingual buprenorphine.
• Patients who successfully transitioned reported minimal to no withdrawal symptoms.
• Transdermal buprenorphine demonstrated potential as a safe and effective microdose induction method.

Implications:

• Transdermal buprenorphine may offer a viable microdose induction strategy for outpatient OUD treatment, particularly for patients using illicit substances.
• This approach could improve treatment accessibility and adherence for individuals transitioning from full opioid agonists.
• Further research is warranted to validate these findings in larger, controlled studies.