Transition from methadone to subcutaneous buprenorphine depot in patients with opioid use disorder - a case report

Introduction Opioid dependence is a complex condition that often requires long-term treatment and care. Methadone, a synthetic full opioid agonist, and buprenorphine, a partial agonist at the opioid receptor, are most commonly used for substitution therapy of opioid dependence and typically administered orally as a liquid and sublingual tablets. Transition from methadone to sublingual buprenorphine may precipitate withdrawal and is usually performed only in patients on low dose of methadone (<30-40 mg). Microdose induction is proposed as a possible solution to ease the transition to buprenorphine. Objectives To present a rapid transition from methadone to sublingual buprenorphine and after that to buprenorphine depot. Methods A case report of a patient who was switched from methadone 60 mg to sublingual buprenorphine 8 mg using microdosing and after that switched to buprenorphine depo 16 mg weekly. Results Patient was successfully switched to sublingual buprenorphine and after that to buprenorphine depot. The transition was complited without withdrawal simptoms. Conclusions This report supports the use of a microdose induction to initiate buprenorphine. Additionally, this approach may be significant for patients stabilized on high doses of methadone who may not be able to tolerate a traditional buprenorphine induction. Disclosure of Interest None Declared