Abstract Introduction Buprenorphine in the treatment of opioid use disorder (OUD) has several benefits including better long-term treatment adherence (1) and is a safer option for many patients due to buprenorphine’s limited potential to cause respiratory depression (4). In comparison to standard buprenorphine induction, induction via micro-dosing does not require a period of withdrawal and dramatically shortens the time required to complete induction. Prior micro-dosing protocols using sublingual (SL) (7-10) and transdermal forms (11) have been reported. We present a case of buprenorphine induction using a novel inpatient intravenous micro-dosing 4-day protocol in a patient on methadone. Case Presentation A 62-year-old man with chronic obstructive pulmonary disease (COPD) on chronic methadone 80mg daily for OUD presented with respiratory failure and was diagnosed with opioid overdose. He was transitioned from a naloxone infusion to intravenous micro-doses of buprenorphine and low dose methadone without experiencing significant withdrawal, and he was discharged on buprenorphine/naloxone SL. Discussion This case demonstrates a successful and well tolerated buprenorphine induction without interruption of methadone treatment or precipitation of significant opioid withdrawal. To the best of our knowledge, this is the first report describing micro-induction with intravenous buprenorphine.

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病例报告或病例系列：接受美沙酮治疗的患者静脉注射丁丙诺啡微剂量诱导：病例报告。

摘要 简介 丁丙诺啡治疗阿片类药物使用障碍 (OUD) 具有多项优势，包括更好的长期治疗依从性 (1)，并且由于丁丙诺啡引起呼吸抑制的可能性有限 (4)，因此对于许多患者而言是更安全的选择。与标准的丁丙诺啡诱导相比，通过微剂量诱导不需要停药期，并且大大缩短了完成诱导所需的时间。使用舌下 (SL) (7-10) 和透皮形式 (11) 的先前微剂量方案已被报道。我们介绍了一个丁丙诺啡诱导的案例，该案例使用一种新的住院患者静脉内微剂量 4 天方案对一名服用美沙酮的患者进行诱导。案例介绍 一名患有慢性阻塞性肺病 (COPD) 的 62 岁男性因 OUD 每天服用 80 毫克慢性美沙酮，出现呼吸衰竭，并被诊断为阿片类药物过量。他从纳洛酮输注过渡到静脉注射微剂量丁丙诺啡和低剂量美沙酮，没有出现明显的戒断反应，出院时服用丁丙诺啡/纳洛酮 SL。讨论 本病例表明丁丙​​诺啡诱导成功且耐受性良好，没有中断美沙酮治疗或显着的阿片类药物戒断沉淀。据我们所知，这是第一份描述静脉注射丁丙诺啡微诱导的报告。他从纳洛酮输注过渡到静脉注射微剂量丁丙诺啡和低剂量美沙酮，没有出现明显的戒断反应，出院时服用丁丙诺啡/纳洛酮 SL。讨论 本病例表明丁丙​​诺啡诱导成功且耐受性良好，没有中断美沙酮治疗或显着的阿片类药物戒断沉淀。据我们所知，这是第一份描述静脉注射丁丙诺啡微诱导的报告。他从纳洛酮输液过渡到静脉注射微剂量丁丙诺啡和低剂量美沙酮，没有出现明显的戒断反应，出院时服用丁丙诺啡/纳洛酮 SL。讨论 本病例表明丁丙​​诺啡诱导成功且耐受性良好，没有中断美沙酮治疗或显着的阿片类药物戒断沉淀。据我们所知，这是第一份描述静脉注射丁丙诺啡微诱导的报告。