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Antoine, Denis; Huhn, Andrew S.; Strain, Eric C.; Turner, Gavin; Jardot, Jasmyne; Hammond, Alexis S.; Dunn, Kelly E.
The American journal on addictions, January 2021, Volume: 30, Issue: 1Journal Article
Background and Objectives Individuals exposed to fentanyl are at risk of precipitated withdrawal using typical buprenorphine/naloxone induction procedures. Methods This case series describes buprenorphine/naloxone inductions of four individuals who tested positive for fentanyl. Results Buprenorphine‐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 Conclusion Using multiple 2 mg doses of buprenorphine/naloxone in patients already in mild/moderate withdrawal improved outcomes. Scientific Significance Persons 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)
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