Workshop: Induction Without Withdrawal: Buprenorphine/Naloxone Micro-Dosing-Workshop: Induction Without Withdrawal: Buprenorphine/Naloxone Micro-Dosing

Video Transcription

Video Summary

Summary:<br /><br />The video features discussions on various low-dose buprenorphine induction techniques and protocols. It highlights challenges in the United States but provides insights on what can be done in Vancouver, Canada. The pharmacology of buprenorphine, including its affinity for mu-opioid receptors, is discussed. The Bernese method, a gradual induction over several days, is introduced along with a modified five-day protocol. The rapid low-dose induction protocol, which aims to achieve a therapeutic dose in 48 hours, is also discussed. The use of full opioid agonists, such as hydromorphone, to manage withdrawal symptoms during induction is mentioned. The video provides valuable insights into different techniques for initiating patients onto opioid agonist therapy.<br /><br />Another focus of the video is the challenges of sustaining buprenorphine therapy in the community. The importance of stabilizing patients in the hospital is emphasized, with a case study illustrating the risks of relapse after discharge. The use of extended-release depot buprenorphine is proposed as a potential treatment option for patients struggling with daily dosing. However, regulations currently restrict its use to those stabilized on sublingual buprenorphine for seven days. An alternative rapid low-dose induction technique using transdermal buprenorphine patches is presented, showing promise in avoiding precipitated withdrawal. The video also touches on low-dose induction for patients with chronic pain and opioid-induced hyperalgesia. Overall, the importance of finding creative solutions to clinical challenges and improving access to buprenorphine therapy is emphasized.<br /><br />Credits:<br />The video features discussions by Martha Ignashevsky, Nick, and Pouya Azhar.

Keywords

low-dose buprenorphine induction

protocols

challenges

pharmacology

Bernese method

rapid low-dose induction

full opioid agonists

withdrawal symptoms

sustaining buprenorphine therapy

extended-release depot buprenorphine

transdermal buprenorphine patches

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