24-Hour Induction of Transdermal Buprenorphine to Buprenorphine Extended-Release.

IF 2.1 4区 医学 Q2 PSYCHOLOGY, CLINICAL Journal of psychoactive drugs Pub Date : 2024-11-19 DOI:10.1080/02791072.2024.2430616
Pouya Azar, Victor W Li, James S H Wong, Mohammadali Nikoo, Jessica Machado, Martha J Ignaszewski, Nickie Mathew, Amer Raheemullah, Sarah E Wakeman, Rodney Mullen, Reinhard M Krausz, Julio S G Montaner, Anil R Maharaj
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Abstract

Buprenorphine is an effective treatment for opioid use disorder but can be slow when using a standard low-dose titration protocol to avoid precipitated withdrawal. This presents a substantial practical barrier in clinical practice. Recent low-dose induction strategies have attempted to simplify and shorten the process required for successful induction, including our own transdermal buprenorphine method, which achieves induction to sublingual buprenorphine/naloxone after 48 h. Here, we present two inpatients with active unregulated fentanyl use that were successfully initiated on buprenorphine extended-release with a novel 24-h transdermal buprenorphine protocol without precipitating withdrawal. This protocol may represent a substantial improvement in the practical feasibility of initiating buprenorphine for patients and providers, although further study is required to confirm efficacy and tolerability.

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经皮丁丙诺啡对丁丙诺啡缓释剂的 24 小时诱导。
丁丙诺啡是一种治疗阿片类药物使用障碍的有效药物,但在使用标准的小剂量滴定方案以避免出现沉淀性戒断时,丁丙诺啡的滴定速度会比较慢。这给临床实践带来了很大的实际障碍。最近的低剂量诱导策略试图简化和缩短成功诱导所需的过程,包括我们自己的经皮丁丙诺啡方法,该方法可在 48 小时后诱导使用舌下丁丙诺啡/纳洛酮。在此,我们介绍了两名使用芬太尼未受管制的住院病人,他们通过一种新型的 24 小时经皮丁丙诺啡方案成功开始使用丁丙诺啡缓释剂,且没有出现骤停。尽管还需要进一步的研究来确认其疗效和耐受性,但对于患者和医疗服务提供者来说,这种方案可能代表着开始使用丁丙诺啡的实际可行性得到了大幅提高。
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来源期刊
CiteScore
5.30
自引率
7.10%
发文量
62
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