An American team has administered small doses of buprenorphine over several days to cause fentanyl withdrawal in people consuming this opioid.
- Adults taking fentanyl every day have received small doses of buprenorphine over four or seven days, because this substance promotes the cessation of the use of the opioid.
- The results indicate that 38 % of people who followed the four -day diet managed to take a full dose of buprenorphine and 28 % succeeded with the seven -day protocol.
- The overall success rate was therefore 34 %.
In recent years, overdoses linked to opioids have exploded. Since then, doctors have been desperately looking for ways to help their patients. They know that buprenorphine can help them stop taking opioids. It is a partial opioid agonist, which means that it only partially binds to the receptor which creates the state of euphoria, without offering the level of euphoria of more powerful opioids.
However, it is much more difficult to start treatment for those who consumed fentanyl, as this substance is stored for a long time in fat cells. Indeed, taking buprenorphine while fentanyl is still active can cause brutal weaning. So that “encourages to explore strategies such as initiation to low -dose buprenorphine. However, there is no comparative research on low -dose administration results”, According to researchers from the University of California in San Francisco (United States).
Opioid crisis: 34 % of patients managed to obtain a full dose of buprenorphine
In a study, published in the journal Jama Network Openthey therefore evaluated the ambulatory results associated with two initiation protocols with a low dose of buprenorphine. For this, the team recruited 126 adults with drug addiction who said they used fentanyl daily. Their data has been extracted from electronic health files from two clinics for processing disorders related to the use of substances. Between May 2021 and November 2022, some participants received small doses of buprenorphine over four days and others over seven days. The objective? Slowly increase the concentration of the drug in their body until it can withstand a higher dose of buprenorphine. For seven days of buprenorphine, the optimal dose was two or three times a day. For four days, it was four times a day.
A total of 175 initiation attempts were recorded. Out of 126 participants, only 34 %, 38 % of whom are as part of a four -day and 28 % protocol as part of a seven -day protocol, managed to obtain a full dose of buprenorphine using this microdosage approach . Overall, 22 % of patients continued to take buprenorphine for at least 28 days. Repeated attempts have given lower success rates than those of the first attempt.
“Improve the success of attempted initiation at low dose of buprenorphine”
According to the authors, these data indicate that it takes more options to help people who are starting to take buprenorphine. From now on, they intend to determine why this promising approach has proven to be less effective than expected. “The next research should examine the interventions to improve the success of attempts to initiation at low dose of buprenorphine and to increase the use of this substance.”
