Rapid Transition from Methadone to Buprenorphine Using Naltrexone-induced Withdrawal: A Case Report

Overview

Journal Subst Abus

Publisher Sage Publications

Specialties Medical Education
Psychiatry

Date 2019 Mar 20

PMID 30888254

Citations 8

Authors

Heather Burrell Ward

Brian S Barnett

Joji Suzuki

Affiliations

Soon will be listed here.

Abstract

Patients taking methadone for opioid use disorder may desire transition to buprenorphine for a number of reasons. However, the current recommended approach for this transition generally takes weeks to months as an outpatient, causing considerable discomfort to the patient and a heightened risk of relapse during the transition period. We describe the case of a patient on methadone maintenance who was rapidly transitioned to buprenorphine because of her desire to not return to her methadone clinic. In order to rapidly transition the patient from methadone to buprenorphine, naltrexone was administered to precipitate acute opioid withdrawal, which was followed soon after by buprenorphine induction. Rapid transition from methadone maintenance to buprenorphine can be accomplished in inpatients by precipitating acute withdrawal with naltrexone, providing an effective alternative for patients who cannot tolerate the typical protracted methadone taper required prior to buprenorphine induction as an outpatient.

Citing Articles

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