Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: A case series Article Swipe
Daniel Shearer
,
Samantha Young
,
Nadia Fairbairn
,
Rupinder Brar
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1111/dar.13394
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1111/dar.13394
Introduction and Aims North America is currently experiencing an epidemic of opioid overdose deaths, driven by the proliferation of fentanyl in the street drug market. Although buprenorphine/naloxone (BUP/NX) is an evidence‐based, first‐line opioid agonist for the management of opioid use disorder, a key challenge in its prescribing lies in the fact that it can precipitate opioid withdrawal during its initial induction process. At this time, there is minimal literature on the BUP/NX induction process in individuals who use illicit fentanyl regularly. Design, Methods and Results A case series from a Vancouver, Canada addiction medicine clinic of three fentanyl‐exposed patients who experienced unexpected, precipitated withdrawal when initiating BUP/NX. Discussion and Conclusion These cases describe incidents of precipitated opioid withdrawal occurring after unusually long periods of fentanyl abstention. Although fentanyl is experienced as a short‐acting opioid, the drug persists much longer in the body's peripheral tissues. Here, we highlight the new challenges fentanyl may pose to current BUP/NX induction strategies, and explore the possibility of a long‐acting pharmacokinetic effect of fentanyl in the setting of repeated illicit use.
Related Topics
Concepts
Fentanyl
Buprenorphine
Context (archaeology)
Opioid
Opioid use disorder
(+)-Naloxone
Medicine
Anesthesia
Addiction
Opioid overdose
Morphine
Psychiatry
Internal medicine
Receptor
Paleontology
Biology
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1111/dar.13394
- OA Status
- green
- Cited By
- 48
- References
- 19
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3206452813
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3206452813Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1111/dar.13394Digital Object Identifier
- Title
-
Challenges with buprenorphine inductions in the context of the fentanyl overdose crisis: A case seriesWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-10-13Full publication date if available
- Authors
-
Daniel Shearer, Samantha Young, Nadia Fairbairn, Rupinder BrarList of authors in order
- Landing page
-
https://doi.org/10.1111/dar.13394Publisher landing page
- Open access
-
YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
-
https://www.ncbi.nlm.nih.gov/pmc/articles/8926080Direct OA link when available
- Concepts
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Fentanyl, Buprenorphine, Context (archaeology), Opioid, Opioid use disorder, (+)-Naloxone, Medicine, Anesthesia, Addiction, Opioid overdose, Morphine, Psychiatry, Internal medicine, Receptor, Paleontology, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
48Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 13, 2024: 17, 2023: 9, 2022: 8, 2021: 1Per-year citation counts (last 5 years)
- References (count)
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19Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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