Long-acting injectable formulations of buprenorphine can be a good treatment option for patients with opioid use disorder, particularly for those with poor adherence. However, starting long-acting injectable medications typically requires the patient to be on a stable dose of sublingual buprenorphine. Here, researchers demonstrate the feasibility of starting buprenorphine with a microinduction approach followed shortly by administration of a long-acting injection.

The process of starting a patient on buprenorphine, called an induction, can be a bit tricky and puts a patient at risk of a precipitated opioid withdrawal. In this article, we discuss the three most common buprenorphine induction approaches, review the pros and cons of each, and include straightforward guidance that will help you perform a successful buprenorphine induction for your patients.