Inpatient transition of methadone to Suboxone via rapid micro-induction in sepsis: a case report

ABSTRACT

Buprenorphine is often preferred over methadone for medication-assisted treatment of opioid use disorder (OUD) because of its superior accessibility and less severe side effect and drug interaction profile; however, a transition from methadone to buprenorphine is made challenging by the prolonged half-life of methadone. Rapid micro-induction of buprenorphine is an up-and-coming strategy that allows the transition from a full opioid agonist to take place within 48 hours and without a traditionally required preceding period of opioid withdrawal syndrome. We report a case of successful inpatient transition from methadone to Suboxone in a patient with OUD and sepsis using a 48-hour rapid micro-induction protocol with pre-induction discontinuation of methadone and discuss the feasibility of this protocol in situations where the transition is time-critical.

KEYWORDS:

• Buprenorphine
• Suboxone
• methadone
• micro-induction
• Bernese

Acknowledgments

We would like to thank the Texas Tech University Health Sciences Center El Paso Paul L. Foster School of Medicine Department of Psychiatry residents and faculty for their support and insight during the management of this complex case.

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No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.