Method for Successfully Inducting Individuals Who Use Illicit Fentanyl Onto Buprenorphine/Naloxone

• DOI: 10.1111/ajad.13069
• Publication Date: 2020-06-23T08:43:10Z
• Authors: Denis Antoine; Andrew S. Huhn; Eric C. Strain; Gavin Turner; Jasmyne Jardot; Alexis S. Hammond; Kelly E. Dunn
• Keywords: Adult; Male; Narcotics; Middle Aged; Opioid-Related Disorders; Substance Withdrawal Syndrome; Analgesics, Opioid; Fentanyl; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Opiate Substitution Treatment; Humans; Female; Buprenorphine, Naloxone Drug Combination

Background and ObjectivesIndividuals exposed to fentanyl are at risk of precipitated withdrawal using typical buprenorphine/naloxone induction procedures.MethodsThis case series describes buprenorphine/naloxone inductions of four individuals who tested positive for fentanyl.ResultsBuprenorphine‐precipitated withdrawal was observed in two individuals who completed a conventional buprenorphine/naloxone induction strategy. Two more individuals completed a revised buprenorphine/naloxone induction strategy that did not precipitate withdrawal.Discussion and ConclusionUsing multiple 2 mg doses of buprenorphine/naloxone in patients already in mild/moderate withdrawal improved outcomes.Scientific SignificancePersons who use illicit fentanyl might be less likely to experience precipitated withdrawal from this revised buprenorphine/naloxone induction strategy. (Am J Addict 2021;30:83–87)