Microdosing Buprenorphine

Microdosing Buprenorphine (Suboxone) for maintenance therapy or for the initiation of an opiate detox is now a relatively accepted treatment option. The concept of microdosing is just as the word implies.  Microdosing is the utilization of a significantly lower dose of a medication than the standard starting dose.  This is especially true when treating clients or patients undergoing Fentanyl withdrawal. The opioid epidemic can now also be referred to as the Fentanyl epidemic.  More often than not, any street based opiate is laced with Fentanyl.

Microdosing for Fentanyl Withdrawal

Microdosing is an option when undergoing Fentanyl withdrawal. The conventional withdrawal management of Fentanyl has often resulted in precipitated withdrawal*. Microdosing buprenorphine allows the introduction of small amounts of this medication while Fentanyl is still clinging to the opioid receptors in the brain. It is not enough to precipitate a moderate to severe withdrawal, it is just enough to begin the transition process.

Microdosing Techniques

Microdosing, at this time, can be done in two different ways: Using a Butrans transdermal patch or using small oral dosages. Executive Home Detox has experience in both these methods and follows accepted protocols.  Of note: Microdosing for Opiate and Fentanyl withdrawal has been discussed and presented at the most recent conference of the American Society of Addiction Medicine in Dallas, TX.

Spontaneous Withdrawal versus *Precipitated Withdrawal

Opiate withdrawal can be classified as Spontaneous Withdrawal or Precipitated Withdrawal. Spontaneous Withdrawal is the result of stopping or cutting back on an opiate once a person is opiate dependent.  Precipitated Withdrawal is the result of taking certain medications to treat opioid use disorder soon after using opioids. Medications that may trigger Precipitated Withdrawal include; Naloxone, Natrexone and Buprenorphine.

Many clients are wary of accepting Buprenorphin treatment because they have experience precipitated withdrawal and they never want to feel that way again.  EHD has had success with a number of clients who have had precipitated withdrawal in the past and were successfully transitioned Buprenorphine using the Microdosing tecnique.