{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:22:14Z","timestamp":1791379334891,"version":"4.3.2"},"reference-count":14,"publisher":"MedWorks Media","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Background\nMethadone is frequently used for chronic pain management due to its long half-life and NMDA receptor activity, making it an effective option for opioid-tolerant patients. Buprenorphine-naloxone is increasingly explored as an alternative for chronic pain and opioid use disorder, offering partial opioid agonism with a ceiling effect on respiratory depression. The transition from methadone to buprenorphine-naloxone remains clinically challenging, requiring careful management to prevent withdrawal and ensure adequate pain control.\nCase Descriptions\nTwo patients with chronic pain were transitioned from methadone to buprenorphine-naloxone. The first patient, a mid-40s female, was abruptly switched from methadone 10 mg twice daily dosing to buprenorphine-naloxone 4 mg-1 mg twice daily dosing without a taper, resulting in severe withdrawal requiring hospitalization. The second patient, a late-50s male, underwent a two-month methadone taper before initiating buprenorphine-naloxone 4 mg-1 mg twice daily dosing, but reported persistent uncontrolled pain despite dose escalation to 4 mg-1 mg three times a day. Both patients reported significant dissatisfaction with buprenorphine-naloxone therapy, citing inadequate pain relief. Both patients eventually left the practice and were lost to follow up.\nConclusion\nThese cases underscore the challenges of transitioning chronic pain patients from methadone to buprenorphine-naloxone formulations. Transitioning patients between these medications may lead to issues regarding withdrawal symptoms, inadequate pain control, and patient attrition.<\/jats:p>","DOI":"10.64719\/pb.4536","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:23:34Z","timestamp":1761045814000},"page":"60-65","source":"Crossref","is-referenced-by-count":3,"title":["Challenges in Transitioning from Methadone to Buprenorphine- Naloxone for Chronic Pain Management: Two Cases"],"prefix":"10.64719","volume":"55","author":[{"given":"Jamal","family":"Hasoon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anvinh","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Viswanath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Abd-Elsayed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Kreutzwiser D, Tawfic QA. 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Health Psychol Res. 2025;13:129552. doi: 10.52965\/001c.129552. Published 2025 Mar 2.","DOI":"10.52965\/001c.129552"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Vu PD, Bansal V, Chitneni A, et al. Buprenorphine for Chronic Pain Management: a Narrative Review. Curr Pain Headache Rep. 2023;27(12):811\u2013820. doi: 10.1007\/s11916-023-01185-4.","DOI":"10.1007\/s11916-023-01185-4"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Poliwoda S, Noor N, Jenkins JS, et al. Buprenorphine and its formulations: a comprehensive review. Health Psychol Res. 2022;10(3):37517. doi: 10.52965\/001c.37517. Published 2022 Aug 20.","DOI":"10.52965\/001c.37517"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Dalal S, Chitneni A, Berger AA, et al. Buprenorphine for Chronic Pain: A Safer Alternative to Traditional Opioids. Health Psychol Res. 2021;9(1):27241. doi: 10.52965\/001c.27241. 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The Journal of Pain. 2014;15(4):321\u2013337.","DOI":"10.1016\/j.jpain.2014.01.494"}],"container-title":["Psychopharmacology Bulletin"],"original-title":[],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T19:33:38Z","timestamp":1791315218000},"score":1,"resource":{"primary":{"URL":"https:\/\/medworksmedia.com\/pb-article\/challenges-in-transitioning-from-methadone-to-buprenorphine-naloxone-for-chronic-pain-management-two-cases\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,8,12]]}},"URL":"https:\/\/doi.org\/10.64719\/pb.4536","relation":{},"ISSN":["2472-2448"],"issn-type":[{"value":"2472-2448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]}}}