48小时经皮丁丙诺啡转换为舌下丁丙诺啡/纳洛酮：IPPAS方法

48-hour Induction of Transdermal Buprenorphine to Sublingual Buprenorphine/Naloxone: The IPPAS Method.

作者信息

Azar Pouya, Wong James S H, Mathew Nickie, Vogel Marc, Perrone Jeanmarie, Herring Andrew A, Krausz Reinhard M, Montaner Julio S G, Greenwald Mark K, Maharaj Anil R

机构信息

From the Integrated Psychiatry, Pain, and Addiction Service, Vancouver General Hospital, Vancouver, British Columbia, Canada (PA, JSHW, NM); Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (PA, NM); Addictions and Concurrent Disorders Research Group, Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (JSHW, RMK); BC Mental Health and Substance Use Services, Provincial Health Services Authority, British Columbia, Canada (NM); University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland (MV); Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (JP); Highland Hospital-Alameda Health System, Department of Emergency Medicine, University of California, San Francisco, California (AAH); British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada (JSGM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (JSGM); Department of Psychiatry and Behavioral Neurosciences, School of Medicine, and Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, (MKG); and Pharmacokinetics Modeling and Simulation Laboratory, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada (AM).

出版信息

J Addict Med. 2023;17(2):233-236. doi: 10.1097/ADM.0000000000001072. Epub 2022 Sep 19.

DOI:10.1097/ADM.0000000000001072

PMID:36149002

Abstract

Buprenorphine is an effective medication for the treatment of opioid use disorder. However, the traditional method of buprenorphine induction requires a period of abstinence and the development of at least moderate withdrawal, which can be barriers in starting treatment. We present the case of a hospitalized patient with opioid use disorder using unregulated fentanyl, who underwent a transdermal buprenorphine induction over 48 hours to initiate sublingual buprenorphine/naloxone on the third day. The patient experienced minimal levels of withdrawal and did not experience precipitated withdrawal. The ease of use of this novel induction method over previously published induction protocols can greatly improve the accessibility of buprenorphine for patients and healthcare staff.

摘要

丁丙诺啡是治疗阿片类物质使用障碍的有效药物。然而，传统的丁丙诺啡诱导方法需要一段时间的戒断且至少要出现中度戒断反应，这可能成为开始治疗的障碍。我们报告一例使用未经监管的芬太尼的阿片类物质使用障碍住院患者的病例，该患者在48小时内接受了经皮丁丙诺啡诱导，以便在第三天开始舌下含服丁丙诺啡/纳洛酮。患者经历的戒断水平极低，未出现急性戒断反应。与先前发表的诱导方案相比，这种新型诱导方法使用方便，可大大提高患者和医护人员获得丁丙诺啡的可及性。