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

Sumantra Monty Ghosh, Sukhpreet Klaire, Robert Tanguay, Mandy Manek, Pouya Azar.

December 1, 2019

Multiple off-label protocols exist for transitioning patients from methadone to buprenorphine, especially at higher doses.
Microdosing and bridging reduce withdrawal risk.
The "Azar Method" using a fentanyl patch is described as an effective bridge.
Most protocols are based on expert consensus, not RCTs.
Clinical judgment is essential; further trials are needed.