Dr. James Darnton discusses micro-dosing (low-dose initiation) of buprenorphine as an option for buprenorphine induction.

0:00 AETC Mountain West
1:22 Disclosures
1:50 Disclaimer
2:26 Properties of Buprenorphine
4:57 Traditional Buprenorphine Induction
5:35 Problems with traditional induction
6:24 Patients on methadone
7:23 Patients with pain
8:06 Illicitly-manufactured fentanyl
10:37 Fentanyl and Norfentanyl Elimination
11:10 Fentanyl overdoses increasing
11:29 Idea behind microdosing
13:05 What's the evidence?
13:46 HMC retrospective cohort study
16:20 Approach to the patient
17:39 Example schedule: 1 week
18:40 Example schedules: 2 week (e.g. patient transitioning from methadone)
19:24 Transdermal patch approach
19:54 Troubleshooting
20:24 Take home points
20:51 References - "Microdosing"
20:57 Acknowledgment