Suboxone microdosing involves taking a smaller-than-average dose of medication for the first few days or weeks to avoid precipitated withdrawal from opioids.
Microdosing is often associated with psychedelic drugs like LSD, but some people use the technique to help them with starting Suboxone.[1]
Never alter your Suboxone dose without talking to your doctor. But if you’re struggling with your medication or worried about starting Suboxone therapy, microdosing might be helpful for you.
Microdosing involves taking very frequent, small Suboxone doses for the first few days or weeks while your body gets used to the medicine without having to abstain from opioids.
In a traditional treatment program, you must quit opioids and enter mild withdrawal to avoid precipitated withdrawal.
Precipitated withdrawal is a severe form of opioid withdrawal that takes hold when people take therapeutic doses of drugs like Suboxone when active opioids are still in their bodies.[8]
Since microdosing involves a smaller dose of Suboxone, it could reduce the need for people to enter withdrawal before starting their medications.
Microdosing is a potential option for two types of patients:
No universally accepted method of Suboxone microdosing exists. Some doctors use the Bernese method, which involves providing buprenorphine doses of 0.2 mg (whereas a traditional program involves doses of 2 mg or higher upon induction.) However, there is no accepted microdosing schedule approved by the FDA or medical officials.[10]
In traditional treatment models, people must first withdraw from drugs like heroin before starting Suboxone. With microdosing, you can skip this step.[6]
In one case study, doctors worked with patients who had used methadone in the hospital to recover from early opioid misuse. They gave low doses of buprenorphine along with methadone, gradually increasing the buprenorphine and lowering the methadone over seven days. On day eight, methadone stopped abruptly. All three patients transitioned successfully.[6]
In a separate study, researchers used intravenous buprenorphine to transfer patients using methadone or other opioids. All were moved to the new medication without experiencing precipitated withdrawal.[9]
In a third study, doctors used at-home microdosing regimens with Suboxone to help people who entered the hospital with opioid use disorders. Of their patients using microdosing, 32% remained in treatment 30 days later.[10]
As these case studies make clear, microdosing routines are variable and can shift by patient need and provider preference. Typically, however, microdosing means taking small, frequent doses of Suboxone unlikely to precipitate withdrawal to help people transition into care.
Microdosing is a relatively new way of using Suboxone and may only be necessary for certain patients who cannot take standard doses of Suboxone.
These people might fit the following criteria:
Seek Medical Guidance to Determine if Microdosing Is Right for You
Suboxone microdosing must be done carefully and requires very specific adherence to the dosing schedule. Since microdosing is a highly specialized form of therapy, your Suboxone provider may not be comfortable trying it.
If you’re interested in microdosing, talk with your provider first. Together, you can create the right plan for your health and sobriety. Never adjust your medication routines without checking with your doctor.
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role of the brain dopamine system in substance use disorders and in aging. He also studies brain function in obesity and eating disorders.
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