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Psychiatry
Buprenorphine ‘microdosing’ method for switching patients with opioid dependence from methadone to buprenorphine
  1. Yesh Chandra Singh,
  2. Shalini Singh,
  3. Roshan Bhad and
  4. Ravindra Rao
  1. National Drug Dependence Treatment Centre, All India Institute of Medical Sciences New Delhi, New Delhi, Delhi, India
  1. Correspondence to Dr Ravindra Rao; drrvrao{at}gmail.com

Abstract

Various factors limit the acceptability of methadone as an opioid agonist treatment (OAT), in which case, buprenorphine becomes the preferred alternative. The classical approach is to gradually taper methadone to a low dose and buprenorphine is initiated after some opioid-free period, which generally takes weeks. A novel approach known as ‘microdosing’ or the ‘Bernese method’ might serve as a valuable alternative. We describe two cases where the patients were successfully transitioned from methadone to buprenorphine using this method.

  • Drugs misuse (including addiction)
  • Psychiatry

https://doi.org/10.1136/bcr-2024-259716

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    Footnotes

    • X @drrvrao

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: YCS, SS, RB and RR. The guarantor is RR. The following authors gave final approval of the manuscript: YCS, SS, RB and RR.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.