34th AM (2023) - Poster Session-Let’s SROM with it: Rotating Methadone to Buprenorphine

Let’s SROM with it: Rotating Methadone to Buprenorphine

Pdf Summary

The study conducted by Tianna Costa, Ari Cuperfain, Maddy Hannah, and Nitin Chopra focuses on the role of slow-release oral morphine (SROM) in switching methadone to buprenorphine, particularly in Canada. Buprenorphine-naloxone (bup/nlx) is considered the preferred first-line treatment option, followed by methadone. However, SROM is an alternative option available in Canada. <br /><br />The use of SROM allows for the continuation of evidence-based opioid agonist therapy (OAT) and preserved tolerance during the transition from methadone to buprenorphine. It also helps manage withdrawal symptoms, cravings, and pain. <br /><br />The study provides three cases that demonstrate the utility of SROM in this transition. Patient A, a 31-year-old male with new-onset psychosis, tolerated the induction well. Patient B, a 34-year-old male with stimulant-induced psychosis, also had a successful transition. Patient C, a 62-year-old female with adherence issues to methadone and suicidal ideation, experienced precipitated withdrawal due to reduced renal function. However, the withdrawal was managed with continued doses of buprenorphine and PRN clonidine. <br /><br />The method of transitioning from methadone to buprenorphine using SROM involves gradually reducing the methadone dose, initiating SROM, and then transitioning to buprenorphine. The specific protocol for each patient is provided in Table 2 of the study.<br /><br />Overall, the study concludes that SROM can be a useful tool in facilitating the transition from methadone to buprenorphine. However, patient factors, including renal function, need to be considered when using this method.

Keywords

slow-release oral morphine

SROM

methadone to buprenorphine

Canada

opioid agonist therapy

withdrawal symptoms

cravings

pain management

transition protocol

renal function

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