Case Report: Buprenorphine-precipitated fentanyl withdrawal treated with high-dose buprenorphine

Background: Buprenorphine, a partial agonist of the mu-opioid receptor, is an increasingly prescribed medication for maintenance treatment opioid use disorder. When this taken in context active use, precipitated withdrawal can occur, leading to acute onset symptoms. Fentanyl complicates buprenorphine, as it slowly releases from body stores and lead higher risk withdrawal. Objectives: Describe successful management buprenorphine fentanyl with high doses buprenorphine. We seek highlight how no adverse effects occurred patient illustrate his stable transition outpatient treatment. Case report: present case severe disorder who presented moderately after taking non-prescribed buprenorphine-naloxone which daily use. He was treated 148 mg over first 48 hours, averaging 63 per day four days. The reported rapid improvement symptoms without noted side able successfully taper 16 twice by discharge. Conclusions: This demonstrates safety effectiveness at withdrawal. While other options include symptomatic management, initiating methadone or less researched like ketamine, utilizing preserve re-establish confidence life-saving medication. also increases previously documented upper boundary on dosing should provide additional its use.