Managing opioid withdrawal precipitated by buprenorphine with buprenorphine

Drug Alcohol Rev. 2021 May;40(4):567-571. doi: 10.1111/dar.13228. Epub 2021 Jan 21.


Buprenorphine is a partial opioid agonist commonly used to treat opioid dependence. The pharmacology of buprenorphine increases the risk of a precipitated opioid withdrawal when commencing patients on buprenorphine treatment, particularly when transferring from long acting opioids (e.g. methadone). There is little documented experience regarding the management of precipitated withdrawal. In our case, a patient developed a significant precipitated opioid withdrawal following buprenorphine administration, and was able to be successfully treated in hospital with further buprenorphine. This demonstrates that rapid increases in buprenorphine dose can be used as an effective treatment for buprenorphine-induced precipitated opioid withdrawal. The use of buprenorphine to manage withdrawal then allows the individual to continue on this highly effective treatment.

Keywords: buprenorphine; opioid dependence; opioid withdrawal; precipitated withdrawal; treatment.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Buprenorphine* / adverse effects
  • Humans
  • Methadone / therapeutic use
  • Narcotic Antagonists / adverse effects
  • Opioid-Related Disorders* / drug therapy
  • Substance Withdrawal Syndrome* / diagnosis
  • Substance Withdrawal Syndrome* / drug therapy


  • Analgesics, Opioid
  • Narcotic Antagonists
  • Buprenorphine
  • Methadone