Department of Psychiatry, Yale University School of Medicine, New Haven, CT (JPD, GG-V); U.S. Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT (JPD, GG-V); Center for Addiction and Mental Health, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada (CF); British Columbia Centre on Substance Use and Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, BC, Canada (SK).
J Addict Med. 2020 Sep/Oct;14(5):e271-e273. doi: 10.1097/ADM.0000000000000618.
Alternative transition protocols from methadone to buprenorphine in the treatment of opioid use disorder (OUD) are needed to reduce the risk of precipitated withdrawal and opioid use during induction.
Case report (n = 1).
One patient with OUD underwent a rapid microinduction outpatient protocol that did not cause precipitated withdrawal or require preceding taper before cessation of methadone. The induction was carried out safely in the outpatient setting.
This report provides a patient-centered approach demonstrating feasibility and cost-effectiveness of rapid transition to buprenorphine in the US outpatient psychiatry setting. Barriers to adherence to opioid agonist therapy may be reduced using this protocol.
阿片类使用障碍（OUD）的治疗中，需要替代美沙酮到丁丙诺啡的转换方案，以降低诱导期内戒断和阿片类药物使用的风险。
病例报告（n=1）。
一名 OUD 患者接受了快速微诱导门诊方案，该方案未导致戒断症状加剧，也无需在停止美沙酮之前进行逐步减量。诱导过程在门诊环境中安全进行。
本报告提供了一种以患者为中心的方法，证明了在美国门诊精神病学环境中快速过渡到丁丙诺啡的可行性和成本效益。使用该方案可能会减少对阿片类激动剂治疗的依从性障碍。
