Buprenorphine-naloxone microdosing: Tools for induction of opioid receptor agonist therapy

Objective: To sensitize family physicians to other techniques that may facilitate treatment with buprenorphine-naloxone in cases of opioid use disorder. SOURCES OF INFORMATION: PubMed was searched for articles using the English keywords buprenorphine, buprenorphine / naloxone, microdosing, opioid agonist therapy and induction . Other guidelines, presentations and resources were also consulted. Main Message: Buprenorphine-naloxone is the first-line option for opioid receptor agonist therapy due to its superior safety profile than methadone. Adoption of this life-saving drug is limited by lack of knowledge and prescription restrictions, but probably the biggest obstacle is the fact that the patient must be in moderate to severe withdrawal before initiating the drug. treatment. An induction option that does not require withdrawal or immediate cessation of current opioid use, called microdosing, is a choice that appeals to patients and a practical approach that can be used by a wider range of practitioners, making it easier to access buprenorphine-naloxone. Family physicians play an important role in the current opioid crisis by helping patients make the transition to opioid receptor agonist therapy. Conclusion: Microdosing is a safe and easy to administer regimen that can be used in a variety of settings with the help of community pharmacists. This article provides an overview of microdosing and serves as a guide to initiate and maintain therapy.