Buprenorphine 'microdosing' method for switching patients with opioid dependence from methadone to buprenorphine.

Transitioning from methadone to buprenorphine for opioid agonist treatment can be limited by factors like withdrawal symptoms and lengthy tapering. A novel approach called microdosing, or the Bernese method, offers a faster alternative. Two cases are described in which patients successfully switched from methadone to buprenorphine using this method, suggesting it may be a valuable option for those who cannot tolerate the classical gradual taper.

Study at a glance

Abstract

Various factors limit the acceptability of methadone as an opioid agonist treatment (OAT), in which case, buprenorphine becomes the preferred alternative. The classical approach is to gradually taper methadone to a low dose and buprenorphine is initiated after some opioid-free period, which generally takes weeks. A novel approach known as 'microdosing' or the 'Bernese method' might serve as a valuable alternative. We describe two cases where the patients were successfully transitioned from methadone to buprenorphine using this method.