{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T16:39:36Z","timestamp":1777653576903,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T00:00:00Z","timestamp":1588118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Canadian Institutes of Health Research (CIHR) Frederick Banting and Charles Best Canada Graduate Scholarships","award":["157934"],"award-info":[{"award-number":["157934"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Addict"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Background and Objectives<\/jats:title><jats:p>Buprenorphine extended\u2010release (BUP\u2010XR) is a monthly injectable form of opioid agonist therapy. Before its administration, a minimum 7\u2010day induction period with a transmucosal buprenorphine\u2010containing product is recommended.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Case report (<jats:italic>n\u2009<\/jats:italic>=\u20091).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 16\u2010year\u2010old female with active, severe opioid use disorder (OUD) and stimulant use disorder, hepatitis C virus, co\u2010occurring mental health disorders, and complex social stressors had five recent overdoses requiring naloxone. She had previously been treated with methadone and several trials of sublingual buprenorphine\/naloxone, but would quickly discontinue the treatment. Using a rapid micro\u2010induction protocol, buprenorphine\/naloxone was administered for 3 days. On day 4, 300\u2009mg BUP\u2010XR was administered subcutaneously. Minimal withdrawal symptoms occurred, despite recent fentanyl use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>A rapid sublingual buprenorphine\/naloxone micro\u2010induction was successfully used to initiate BUP\u2010XR, thereby eliminating the abstinence period prior to buprenorphine\/naloxone administration, shortening the induction period, and minimizing withdrawal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Scientific Significance<\/jats:title><jats:p>This is the first reported case of using rapid micro\u2010induction as a bridge to initiate BUP\u2010XR. By reducing the length of induction to 4 days and minimizing withdrawal, this induction method can make BUP\u2010XR more accessible to patients who would otherwise refuse the medication due to concerns of enduring withdrawal. 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