Patient-elected low-dose intravenous naloxone for rapid buprenorphine induction: a case report.

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2025-05-14 DOI:10.1186/s13722-025-00572-z

Pouya Azar, Jessica Machado, Jane J Kim, James S H Wong, Mohammadali Nikoo, Victor W Li

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引用次数: 0

Abstract

Background: Buprenorphine is a common partial opioid agonist treatment for opioid use disorder (OUD). Despite its efficacy, major challenges to induction include the significant time consumption and the difficult requirement for patients to be in moderate opioid withdrawal.

Case presentation: We present the case of a 31-year-old man with severe OUD and regular fentanyl use who was successfully initiated on buprenorphine-naloxone using low-dose intravenous naloxone in ten minutes and administered 300 mg of extended-release injectable buprenorphine within two hours. This involved the rapid administration of small doses of intravenous naloxone with an assessment of withdrawal symptoms after each dose. Buprenorphine-naloxone is immediately administered once moderate withdrawal is reached.

Conclusions: Low-dose intravenous naloxone provides an alternative method of buprenorphine induction that limits the experience of withdrawal to a shorter time window compared to existing protocols.

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患者选择低剂量静脉纳洛酮快速丁丙诺啡诱导：一例报告。

背景：丁丙诺啡是治疗阿片类药物使用障碍（OUD）的常用部分阿片类药物激动剂。尽管其疗效显著，但诱导的主要挑战包括大量的时间消耗和对患者适度阿片类药物戒断的困难要求。病例介绍：我们报告了一例31岁的严重OUD患者，经常使用芬太尼，他在10分钟内使用低剂量静脉注射纳洛酮，并在2小时内给予300毫克的缓释注射丁丙诺啡。这包括快速给予小剂量静脉注射纳洛酮，并在每次给药后评估戒断症状。一旦达到中度戒断，立即给予丁丙诺啡-纳洛酮。结论：与现有方案相比，低剂量静脉纳洛酮提供了丁丙诺啡诱导的另一种方法，将戒断经验限制在更短的时间窗口内。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.