{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T00:26:32Z","timestamp":1783124792322,"version":"3.54.6"},"reference-count":6,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Buprenorphine is a partial opioid agonist that is Food and Drug Administration (FDA) approved to treat chronic pain and opioid use disorder (OUD). The national prescribing guidelines in the United States (US) recommend that patients transitioning from full opioid agonists to buprenorphine first undergo 12 or more hours of active opioid withdrawal, in order to avoid buprenorphine-precipitated opioid withdrawal. This opioid-free period imposes a significant barrier for many patients. Evidence is accumulating that using microdoses of buprenorphine to cross taper from full-agonist opioids to buprenorphine is a safe and effective way to avoid opioid withdrawal and uncontrolled pain. This microdose cross-tapering strategy is already being used across the US. The US prescribing guidelines and buprenorphine training would benefit from acknowledging this new approach. Additionally, to facilitate this strategy, the FDA should approve transdermal buprenorphine formulations for OUD and manufacturers could produce lower dose formulations of sublingual buprenorphine. The time has come for us to embrace buprenorphine microdosing cross tapers as a new standard of care.<\/jats:p>","DOI":"10.3390\/ijerph192416436","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T01:44:31Z","timestamp":1670463871000},"page":"16436","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Buprenorphine Microdosing Cross Tapers: A Time for Change"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4651-634X","authenticated-orcid":false,"given":"Amer","family":"Raheemullah","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4806-2636","authenticated-orcid":false,"given":"Ori-Michael","family":"Benhamou","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lembke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA 94305, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1089\/jpm.2021.0378","article-title":"Buprenorphine microdosing for the pain and palliative care clinician","volume":"25","author":"Quirk","year":"2022","journal-title":"J. Palliat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/S0006-3223(96)00266-1","article-title":"Buprenorphine and naloxone interactions in methadone maintenance patients","volume":"41","author":"Mendelson","year":"1997","journal-title":"Biol. Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e504","DOI":"10.1097\/MJT.0000000000001108","article-title":"Buprenorphine Induction without Opioid Withdrawal: A Case Series of 15 Opioid-Dependent Inpatients Induced on Buprenorphine Using Microdoses of Transdermal Buprenorphine","volume":"28","author":"Raheemullah","year":"2019","journal-title":"Am. J. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"70","DOI":"10.7326\/L19-0725","article-title":"Switching from high-dose, long-term opioids to buprenorphine: A case series","volume":"173","author":"Becker","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1097\/CXA.0000000000000072","article-title":"A review of novel methods to support the transition from methadone and other full agonist opioids to buprenorphine\/naloxone sublingual in both community and acute care settings","volume":"10","author":"Ghosh","year":"2019","journal-title":"Can. J. Addict."},{"key":"ref_6","first-page":"258","article-title":"An exploratory study of suboxone (buprenorphine\/naloxone) film splitting: Cutting methods, content uniformity, and stability","volume":"23","author":"Reindel","year":"2019","journal-title":"Int. J. Pharm. Compound."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16436\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:36:05Z","timestamp":1760146565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/24\/16436"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,8]]},"references-count":6,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192416436"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192416436","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,8]]}}}