Outpatient Buprenorphine Microinduction for Pain “A Safe Method to Transition High-Risk Patients”

During the June 2021 Annual Meeting’s Fellows Lightning Round session, Bhavna Bali, MD, a 2021 graduate of the Interdisciplinary Addiction Medicine Fellowship at Penn State College of Medicine, shared her research titled Outpatient Buprenorphine Microinduction for Pain “A Safe Method to Transition High-Risk Patients.”

After reviewing the basics of microdosing buprenorphine, Dr. Bali’s presentation focused on a specific case where a high-risk patient on high-dose opioids was transitioned to suboxone for pain management. The patient in question had been diagnosed with Physiological Opioid Dependence with a high risk of developing Opioid Use Disorder.

In this case, the patient was successfully transitioned to buprenorphine using a butrans patch and microdosing of suboxone. While she did not have therapeutic relief of pain, she did have minimal precipitated withdrawal symptoms with successful transition. What makes this case even more remarkable is that after the patient’s transition was completed it was discovered that she was using illicit fentanyl and still had minimal precipitated withdrawal symptoms.

Download and reference Dr. Bali’s presentation slides.

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