Factors that distinguish opioid withdrawal during induction with buprenorphine microdosing: a configurational analysis
Addiction Science & Clinical Practice October 4, 2022 Adams K. K., Miech E. J., Sobieraj D. M.
Among patients with opioid use disorder who used a buprenorphine microdosing strategy to transition from a full opioid agonist without first experiencing withdrawal, a history of heroin use, a history of methadone use, and the duration of overlap between buprenorphine and the full opioid agonist during induction consistently distinguished those who experienced withdrawal from those who did not. For patients who did experience withdrawal, the buprenorphine starting dose was an additional distinguishing factor; for those who did not, the overall induction duration was an additional factor. The analysis included 14 cases from a systematic review; 9 of those cases involved withdrawal symptoms.