View Item 

Show simple item record

Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review
dc.contributor.authorSpreen, Lauren A.
dc.contributor.authorDittmar, Emma N.
dc.contributor.authorQuirk, Kyle C.
dc.contributor.authorSmith, Michael A.
dc.date.accessioned2022-06-01T20:31:36Z
dc.date.available2023-06-01 16:31:34en
dc.date.available2022-06-01T20:31:36Z
dc.date.issued2022-05
dc.identifier.citationSpreen, Lauren A.; Dittmar, Emma N.; Quirk, Kyle C.; Smith, Michael A. (2022). "Buprenorphine initiation strategies for opioid use disorder and pain management: A systematic review." Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy (5): 411-427.
dc.identifier.issn0277-0008
dc.identifier.issn1875-9114
dc.identifier.urihttps://hdl.handle.net/2027.42/172861
dc.description.abstractBuprenorphine possesses many unique attributes that make it a practical agent for adults and adolescents with opioid use disorder (OUD) and/or acute or chronic pain. Sublingual buprenorphine has been the standard of care for treating OUD, but its use in pain management is not as clearly defined. Current practice guidelines recommend a period of mild-to-moderate withdrawal from opioids before transitioning to buprenorphine due to its ability to displace full agonists from the μ-opioid receptor. However, this strategy can lead to negative physical and psychological outcomes for patients. Novel initiation strategies suggest that concomitant administration of small doses of buprenorphine with opioids can avoid the unwanted withdrawal associated with buprenorphine initiation. We aim to systematically review the buprenorphine initiation strategies that have emerged in the last decade. Embase, PubMed, and Cochrane Databases were searched for relevant literature. Studies were included if they were published in the English language and described the transition to buprenorphine from opioids. Data were collected from each study and synthesized using descriptive statistics. This review included 7 observational studies, 1 feasibility study, and 39 case reports/series which included 924 patients. The strategies utilized between the literature included traditional initiation (47.9%), microdosing with various buprenorphine formulations (16%), and miscellaneous methods (36.1%). Traditional initiation and microdosing initiation were compared in the data synthesis and analysis; miscellaneous methods were omitted given the high variability between methods. Overall, 95.6% of patients in the traditional initiation group and 96% of patients in the microdosing group successfully rotated to sublingual buprenorphine. Initiation regimens can vary widely depending on patient-specific factors and buprenorphine formulation. A variety of buprenorphine transition strategies are published in the literature, many of which were effective for patients with OUD, pain, or both.
dc.publisherWiley Periodicals, Inc.
dc.publisherStatPearls Publishing
dc.subject.otherchronic pain
dc.subject.otherinitiation
dc.subject.otheropioid use disorder
dc.subject.otherbuprenorphine
dc.titleBuprenorphine initiation strategies for opioid use disorder and pain management: A systematic review
dc.typeArticle
dc.rights.robotsIndexNoFollow
dc.subject.hlbsecondlevelPharmacy and Pharmacology
dc.subject.hlbtoplevelHealth Sciences
dc.description.peerreviewedPeer Reviewed
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172861/1/phar2676.pdf
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/172861/2/phar2676_am.pdf
dc.identifier.doi10.1002/phar.2676
dc.identifier.sourcePharmacotherapy: The Journal of Human Pharmacology and Drug Therapy
dc.identifier.citedreferenceIrwin M, Petersen KS, Smith MA. Rapid buprenorphine induction for cancer pain in pregnancy. J Palliat Med. 2021; 24 ( 8 ): 1257 - 1262. doi: 10.1089/jpm.2020.0524
dc.identifier.citedreferenceLee DS, Hann JE, Klaire SS, Nikoo M, Negraeff MD, Rezazadeh-Azar P. Rapid induction of buprenorphine/naloxone for chronic pain using a microdosing regimen: a case report. A A Pract. 2020; 14 ( 2 ): 44 - 47. doi: 10.1213/XAA.0000000000001138
dc.identifier.citedreferenceBecker WC, Frank JW, Edens EL. Switching from high-dose, long-term opioids to buprenorphine: a case series. Ann Intern Med. 2020; 173 ( 1 ): 70 - 71. doi: 10.7326/L19-0725
dc.identifier.citedreferenceCrum IT, Meyer Karre VM, Balasanova AA. Transitioning from intrathecal hydromorphone to sublingual buprenorphine-naloxone through microdosing: a case report. A A Pract. 2020; 14 ( 11 ): e01316. doi: 10.1213/XAA.0000000000001316
dc.identifier.citedreferenceTara A, Acampora G, Wang J, De Sousa K, Zhang Y. Facilitating discontinuation of intravenous opioids by -concurrent use of sublingual buprenorphine with rapid microdosing -induction: a pain management case study. J Opioid Manag. 2021; 17 ( 7 ): 153 - 158. doi: 10.5055/jom.2021.0652
dc.identifier.citedreferenceKornfeld H, Reetz H. Transdermal buprenorphine, opioid rotation to sublingual buprenorphine, and the avoidance of precipitated withdrawal: a review of the literature and demonstration in three chronic pain patients treated with butrans. Am J Ther. 2015; 22 ( 3 ): 199 - 205. doi: 10.1097/MJT.0b013e31828bfb6e
dc.identifier.citedreferenceWeimer MB, Guerra M, Morrow G, Adams K. Hospital-based buprenorphine micro-dose initiation. J Addict Med. 2021; 15 ( 3 ): 255 - 257. doi: 10.1097/ADM.0000000000000745
dc.identifier.citedreferenceKlaire S, Zivanovic R, Barbic SP, Sandhu R, Mathew N, Azar P. Rapid micro-induction of buprenorphine/naloxone for opioid use disorder in an inpatient setting: a case series. Am J Addict. 2019; 28 ( 4 ): 262 - 265. doi: 10.1111/ajad.12869
dc.identifier.citedreferenceMortaji P, Terasaki D, Moo-Young J. Advanced inpatient management of opioid use disorder in a patient requiring serial surgeries. J Gen Intern Med. 2021; 36 ( 8 ): 2448 - 2451. doi: 10.1007/s11606-021-06739-z
dc.identifier.citedreferenceMartin L, Lennox R, Regenstreif L, O’Shea T. Case report: “striving to skip the withdrawal” using buprenorphine-naloxone microdosing for hospitalized patients. Can J Addict. 2019; 10: 35 - 40. doi: 10.1097/CXA.0000000000000048
dc.identifier.citedreferenceSandhu R, Zivanovic R, Klaire S, Nikoo M, Rozylo J, Azar P. Buprenorphine/naloxone induction for treatment of acute on chronic pain using a micro-dosing regimen: a case report. Can J Pain. 2019; 3 ( 1 ): 79 - 84. doi: 10.1080/24740527.2019.1599279
dc.identifier.citedreferenceHamata B, Griesdale D, Hann J, Rezazadeh-Azar P. Rapid micro-induction of buprenorphine/naloxone for opioid use disorder in a critically ill intubated patient: a case report. J Addict Med. 2020; 14 ( 6 ): 514 - 517. doi: 10.1097/ADM.0000000000000675
dc.identifier.citedreferenceStanciu CN, Gibson S, Teja N, Healey CJ. An efficient and smooth methadone-to-buprenorphine transition protocol utilizing a transdermal fentanyl bridge and a pharmacokinetic inducer: the Stanciu method. Cureus. 2020; 27 ( 12 ): e8310. doi: 10.7759/cureus.8310
dc.identifier.citedreferenceThakrar AP, Jablonski L, Ratner J, Rastegar DA. Micro-dosing intravenous buprenorphine to rapidly transition from full opioid agonists. J Addict Med. 2022; 16 ( 1 ): 122 - 124. doi: 10.1097/ADM.0000000000000838
dc.identifier.citedreferenceMoe J, O’Sullivan F, Hohl CM, et al. Short Communication: Systematic review on effectiveness of micro-induction approaches to buprenorphine initiation. Addict Behav. 2021; 114: 106740. doi: 10.1016/j.addbeh.2020.106740
dc.identifier.citedreferenceAdams KK, Machnicz M, Sobieraj DM. Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: a systematic review. Addict Sci Clin Pract. 2021; 16 ( 1 ): 36. doi: 10.1186/s13722-021-00244-8
dc.identifier.citedreferenceAhmed S, Bhivandkar S, Lonergan BB, Suzuki J. Microinduction of buprenorphine/naloxone: a review of the literature. Am J Addict. 2021; 30 ( 4 ): 305 - 315. doi: 10.1111/ajad.13135
dc.identifier.citedreferenceQuirk K, Stevenson M. Buprenorphine microdosing for the pain and palliative care clinician. J Palliat Med. 2022; 25 ( 1 ): 145 - 154. doi: 10.1089/jpm.2021.0378
dc.identifier.citedreferenceRandhawa PA, Brar R, Nolan S. Buprenorphine-naloxone, "microdosing": an alternative induction approach for the treatment of opioid use disorder in the wake of North America’s increasingly potent illicit drug market. CMAJ. 2020; 192 ( 3 ): E73. doi: 10.1503/cmaj.74018
dc.identifier.citedreferenceHerring AA, Vosooghi AA, Luftig J, et al. High-dose buprenorphine induction in the emergency department for treatment of opioid use disorder. JAMA Netw Open. 2021; 4 ( 7 ): e2117128. doi: 10.1001/jamanetworkopen.2021.17128
dc.identifier.citedreferenceHess M, Boesch L, Leisinger R, Stohler R. Transdermal buprenorphine to switch patients from higher dose methadone to buprenorphine without severe withdrawal symptoms. Am J Addict. 2011; 20 ( 5 ): 480 - 481. doi: 10.1111/j.1521-0391.2011.00159.x
dc.identifier.citedreferenceAzar P, Nikoo M, Miles I. Methadone to buprenorphine/naloxone induction without withdrawal utilizing transdermal fentanyl bridge in an inpatient setting-Azar method. Am J Addict. 2018; 27 ( 8 ): 601 - 604. doi: 10.1111/ajad.12809
dc.identifier.citedreferenceTang VM, Lam-Shang-Leen J, Brothers TD, et al. Case series: limited opioid withdrawal with use of transdermal buprenorphine to bridge to sublingual buprenorphine in hospitalized patients. Am J Addict. 2020; 29 ( 1 ): 73 - 76. doi: 10.1111/ajad.12964
dc.identifier.citedreferenceIrwin M, Gunther W, Keefer P, et al. Buprenorphine for chronic pain in a pediatric patient with sickle-cell disease. J Pain Symptom Manage. 2021; 62 ( 5 ): 1086 - 1091. doi: 10.1016/j.jpainsymman.2021.04.007
dc.identifier.citedreferencePathan H, Williams J. Basic opioid pharmacology: an update. Br J Pain. 2012; 6 ( 1 ): 11 - 16. doi: 10.1177/2049463712438493
dc.identifier.citedreferenceCunningham C, Edlund MJ, Fishman M. The ASAM national practice guideline for the treatment of opioid use disorder: 2020 focused update. Am Soc Addict Med. 2020; 14 ( 2S ): 1 - 91. doi: 10.1097/ADM.0000000000000633
dc.identifier.citedreferenceU.S Food and Drug Administration. Drug approval package. 2004. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2002/20732_20733_subutex.cfm#:%7E:text=Approval%20Date:%2010/08/2002. Accessed March 11, 2022.
dc.identifier.citedreferenceSubutex [package insert]. North Chesterfield, VA; Indivior Inc. 2002. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020732s018lbl.pdf. Accessed March 11, 2022.
dc.identifier.citedreferenceWebster L, Gudin J, Raffa RB, et al. Understanding buprenorphine for use in chronic pain: expert opinion. Pain Med. 2020; 21 ( 4 ): 714 - 723.
dc.identifier.citedreferenceChen KY, Chen L, Mao J. Buprenorphine-naloxone therapy in pain management. Anesthesiology. 2014; 120 ( 5 ): 1262 - 1274. doi: 10.1097/ALN.0000000000000170
dc.identifier.citedreferenceKumar R, Viswanath O, Saadabadi A. Buprenorphine. In: StatPearls [Internet]. StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK459126. Accessed March 11, 2022.
dc.identifier.citedreferenceDavis MP, Pasternak G, Behm B. Treating chronic pain: an overview of clinical studies centered on the buprenorphine option. Drugs. 2018; 78 ( 12 ): 1211 - 1228. doi: 10.1007/s40265-018-0953-z
dc.identifier.citedreferenceBurgess DJ, Vallone D, Bair MJ, Matthias MS, Taylor BC, Taylor SL. Shifting the national consciousness about pain treatment: the critical need for a national public education campaign. J Pain. 2021; 22 ( 10 ): 1129 - 1133. doi: 10.1016/j.jpain.2021.03.156
dc.identifier.citedreferenceHumphreys K, Shover CL, Andrews CM, et al. Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission. Lancet. 2022; 399 ( 10324 ): 555 - 604. doi: 10.1016/S0140-6736(21)02252-2
dc.identifier.citedreferenceDowell D, Haegerich T, Chou R. No shortcuts to safer opioid prescribing. N Engl J Med. 2019; 380 ( 24 ): 2285 - 2287. doi: 10.1056/NEJMp1904190
dc.identifier.citedreferencePowell VD, Rosenberg JM, Yaganti A, et al. Evaluation of buprenorphine rotation in patients receiving long-term opioids for chronic pain: a systematic review. JAMA Netw Open. 2021; 4 ( 9 ): e2124152. doi: 10.1001/jamanetworkopen.2021.24152
dc.identifier.citedreferenceJuurlink DN. Rethinking "doing well" on chronic opioid therapy. CMAJ. 2017; 189 ( 39 ): E1222 - E1223. doi: 10.1503/cmaj.170628
dc.identifier.citedreferenceVolpe DA, McMahon Tobin GA, Mellon RD, et al. Uniform assessment and ranking of opioid μ receptor binding constants for selected opioid drugs. Regul Toxicol Pharmacol. 2011; 59 ( 3 ): 385 - 390. doi: 10.1016/j.yrtph.2010.12.007
dc.identifier.citedreferenceCoe MA, Lofwall MR, Walsh SL. Buprenorphine pharmacology review: update on transmucosal and long-acting formulations. J Addict Med. 2019; 13 ( 2 ): 93 - 103. doi: 10.1097/ADM.0000000000000457
dc.identifier.citedreferenceChristoph T, Kögel B, Schiene K, Méen M, De Vry J, Friderichs E. Broad analgesic profile of buprenorphine in rodent models of acute and chronic pain. Eur J Pharmacol. 2005; 10 ( 507 ): 87 - 98. doi: 10.1016/j.ejphar.2004.11.052
dc.identifier.citedreferenceSilverman SM. Opioid induced hyperalgesia: clinical implications for the pain practitioner. Pain Phys. 2009; 12 ( 3 ): 679 - 684.
dc.identifier.citedreferenceHser YI, Saxon AJ, Huang D, et al. Treatment retention among patients randomized to buprenorphine/naloxone compared to methadone in a multi-site trial. Addiction. 2014; 109 ( 1 ): 79 - 87. doi: 10.1111/add.12333
dc.identifier.citedreferenceTeruya C, Schwartz RP, Mitchell SG, et al. Patient perspectives on buprenorphine/naloxone: a qualitative study of retention during the starting treatment with agonist replacement therapies (START) study. J Psychoactive Drugs. 2014; 46 ( 5 ): 412 - 426. doi: 10.1080/02791072.2014.921743
dc.identifier.citedreferenceKelty E, Hulse G. Fatal and non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone. Int J Drug Policy. 2017; 46: 54 - 60. doi: 10.1016/j.drugpo.2017.05.039
dc.identifier.citedreferenceSuboxone [package insert]. North Chesterfield, VA; Indivior Inc. 2002. https://www.suboxone.com/pdfs/prescribing-information.pdf. Accessed March 11, 2022.
dc.identifier.citedreferencePage MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021; 10: 89.
dc.identifier.citedreferenceJoanna Briggs Institute. Checklist for Case Reports; 2020.
dc.identifier.citedreferenceJoanna Briggs Institute. Checklist for Case Series; 2020.
dc.identifier.citedreferenceJoanna Briggs Institute. Checklist for Cohort Studies; 2020.
dc.identifier.citedreferenceMariani JJ, Mahony A, Iqbal MN, Luo SX, Naqvi NH, Levin FR. Case Series: Rapid induction onto long acting buprenorphine injection for high potency synthetic opioid users. Am J Addict. 2020; 29 ( 4 ): 345 - 348. doi: 10.1111/ajad.13018
dc.identifier.citedreferenceMoe J, Badke K, Pratt M, et al. Microdosing and standard-dosing take-home buprenorphine from the emergency department: a feasibility study. J Am Coll Emerg Physicians Open. 2020; 1 ( 6 ): 1712 - 1722. doi: 10.1002/emp2.12289
dc.identifier.citedreferenceJones HE, Suess P, Jasinski DR, Johnson RE. Transferring methadone-stabilized pregnant patients to buprenorphine using an immediate release morphine transition: an open-label exploratory study. Am J Addict. 2006; 15 ( 1 ): 61 - 70. doi: 10.1080/10550490500419094
dc.identifier.citedreferenceAgapoff JR, Kilaru U. Outpatient buprenorphine induction and maintenance treatment for kratom dependence: a case study. J Subst Use. 2019; 24 ( 6 ): 575 - 577. doi: 10.1080/14659891.2019.1638459
dc.identifier.citedreferenceHammig R, Kemter A, Strasser J, et al. Use of microdoses for induction of buprenorphine treatment with overlapping full opioid agonist use: the Bernese method. Subst Abuse Rehabil. 2016; 7: 99 - 105.
dc.identifier.citedreferenceRozylo J, Mitchell K, Nikoo M, et al. Case Report: Successful induction of buprenorphine/naloxone using a microdosing schedule and assertive outreach. Addict Sci Clin Pract. 2020; 15 ( 1 ): 2. doi: 10.1186/s13722-020-0177-x
dc.identifier.citedreferenceCaulfield MDG, Brar R, Sutherland C, Nolan S. Transitioning a patient from injectable opioid agonist therapy to sublingual buprenorphine/naloxone for the treatment of opioid use disorder using a microdosing approach. BMJ Case Rep. 2020; 13 ( 3 ): e233715. doi: 10.1136/bcr-2019-233715
dc.identifier.citedreferencePayler DK. Substitution of heroin and methadone with buprenorphine using an overlap method without needing to wait for withdrawal. Drugs Alcohol Today. 2016; 16: 259 - 266.
dc.identifier.citedreferenceAzar P, Wong JSH, Jassemi S, et al. A case report: rapid micro-induction of buprenorphine/naloxone to administer buprenorphine extended-release in an adolescent with severe opioid use disorder. Am J Addict. 2020; 29 ( 6 ): 531 - 535. doi: 10.1111/ajad.13050
dc.identifier.citedreferenceRobbins JL, Englander H, Gregg J. Buprenorphine microdose induction for the management of prescription opioid dependence. J Am Board Fam Med. 2021; 34: S141 - S146. doi: 10.3122/jabfm.2021.S1.200236
dc.identifier.citedreferenceBrar R, Fairbairn N, Sutherland C, Nolan S. Use of a novel prescribing approach for the treatment of opioid use disorder: Buprenorphine/naloxone micro-dosing – a case series. Drug Alcohol Rev. 2020; 39 ( 5 ): 588 - 594. doi: 10.1111/dar.13113
dc.identifier.citedreferenceDeWeese JP, Krenz JR, Wakeman SE, Peckham AM. Rapid buprenorphine microdosing for opioid use disorder in a hospitalized patient receiving very high doses of full agonist opioids for acute pain management: titration, implementation barriers, and strategies to overcomes. Subst Abus. 2021; 4: 1 - 6. doi: 10.1080/08897077.2021.1915914
dc.identifier.citedreferenceVogel M, Köck P, Strasser J, Wiesbeck G, Walter M, Dürsteler KM. Chronic high-dose buprenorphine does not block subjective high from diacetylmorphine in a patient in heroin-assisted treatment. J Psychoactive Drugs. 2019; 51 ( 4 ): 377 - 382. doi: 10.1080/02791072.2019.1610200
dc.identifier.citedreferenceVytialingam RC, Schug SA, O’Regan R. Successful rotation from long-acting full agonist opioids to sublingual buprenorphine/naloxone using a microdosing approach. J Opioid Manag. 2021; 17 ( 7 ): 159 - 166. doi: 10.5055/jom.2021.0653
dc.identifier.citedreferenceWard HB, Barnett BS, Suzuki J. Rapid transition from methadone to buprenorphine using naltrexone-induced withdrawal: a case report. Subst Abus. 2019; 40 ( 2 ): 140 - 145. doi: 10.1080/08897077.2019.1573776
dc.identifier.citedreferenceBerland DW, Malinoff HL, Weiner MA, Przybylski R. When opioids fail in chronic pain management: the role for buprenorphine and hospitalization. Am J Ther. 2013; 20 ( 4 ): 316 - 321. doi: 10.1097/MJT.0b013e31827ab599
dc.identifier.citedreferenceJafari S, Rafizadeh R. Successful transition from high-dose methadone to buprenorphine via microdosing in the outpatient setting: a case report. Can J Hosp Pharm. 2021; 74 ( 1 ): 83 - 85.
dc.identifier.citedreferenceTerasaki D, Smith C, Calcaterra SL. Transitioning hospitalized patients with opioid use disorder from methadone to buprenorphine without a period of opioid abstinence using a microdosing protocol. Pharmacotherapy. 2019; 39 ( 10 ): 1023 - 1029. doi: 10.1002/phar.2313
dc.identifier.citedreferenceSingh G, Sri Konakanchi J, Betsch B, Thapa A, Sethi R. Rapid microinduction of sublingual buprenorphine from methadone in an outpatient setting: "A case series". J Opioid Manag. 2021; 17 ( 7 ): 167 - 170. doi: 10.5055/jom.2021.0654
dc.identifier.citedreferenceButton D, Hartley J, Robbins J, Levander XA, Smith NJ, Englander H. Low-dose buprenorphine initiation in hospitalized adults with opioid use disorder: a retrospective cohort analysis. J Addict Med. 2022; 16 ( 2 ): e105 - e111. doi: 10.1097/ADM.0000000000000864
dc.identifier.citedreferenceSaal D, Lee F. Rapid induction therapy for opioid-use disorder using buprenorphine transdermal patch: a case series. Perm J. 2020; 24:19.124. doi: 10.7812/TPP/19.124
dc.identifier.citedreferenceRaheemullah A, Lembke A. Buprenorphine induction without opioid withdrawal: a case series of 15 opioid-dependent inpatients induced on buprenorphine using microdoses of transdermal buprenorphine. Am J Ther. 2021; 28 ( 4 ): e504 - e508. doi: 10.1097/MJT.0000000000001108
dc.identifier.citedreferenceDe Aquino JP, Fairgrieve C, Klaire S, Garcia-Vassallo G. Rapid transition from methadone to buprenorphine utilizing a micro-dosing protocol in the outpatient veteran affairs setting. J Addict Med. 2020; 14 ( 5 ): e271 - e273. doi: 10.1097/ADM.0000000000000618
dc.identifier.citedreferenceCortina S, Mihic T, Fennemore M, McLean M. Case report: high-dose methadone transition to buprenorphine/naloxone in an inpatient with a prolonged QT interval. Addict Med. 2017; 8 ( 1 ): 25 - 28. doi: 10.1097/02024458-201706000-00006
dc.identifier.citedreferenceCrane K, Snead J, Stanley R, Avery J, Ghosh SM, Mints G. Intravenous buprenorphine micro-dosing induction in a patient on methadone treatment: a case report. J Acad Consult Liaison Psychiatry. 2021; 62 ( 2 ): 243 - 247. doi: 10.1016/j.psym.2020.07.004
dc.identifier.citedreferenceMalinoff HL, Wilson G, Barkin RL. Sublingual buprenorphine is effective in the treatment of chronic pain syndrome. Am J Ther. 2005; 12 ( 5 ): 379 - 384.
dc.identifier.citedreferenceDaitch J, Frey ME, Silver D, Mitnick C, Daitch D, Pergolizzi J Jr. Conversion of chronic pain patients from full-opioid agonists to sublingual buprenorphine. Pain Phys. 2012; 15 ( 3 Suppl ): ES59 - ES66.
dc.identifier.citedreferenceRosenblum A, Cruciani RA, Strain EC, et al. Sublingual buprenorphine/naloxone for chronic pain in at-risk patients: development and pilot test of a clinical protocol. J Opioid Manag. 2012; 8 ( 6 ): 369 - 382. doi: 10.5055/jom.2012.0137
dc.identifier.citedreferenceBuchheit BM, Joslin T, Turner HN, Wong TE. Ambulatory microdose induction of buprenorphine-naloxone in two adolescent patients with sickle cell disease. Pediatr Blood Cancer. 2021; 68 ( 1 ): e28766. doi: 10.1002/pbc.28766
dc.working.doiNOen
dc.owningcollnameInterdisciplinary and Peer-Reviewed


Files in this item

Name:
phar2676.pdf
Size:
1.041MB
Format:
PDF
View/Open
Name:
phar2676_am.pdf
Size:
416.3KB
Format:
PDF
View/Open

Show simple item record

Remediation of Harmful Language

The University of Michigan Library aims to describe its collections in a way that respects the people and communities who create, use, and are represented in them. We encourage you to Contact Us anonymously if you encounter harmful or problematic language in catalog records or finding aids. More information about our policies and practices is available at Remediation of Harmful Language.

Accessibility

If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.