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Stabilization phase (1-2 months):
❑ Transition when patient has:
  • No withdrawal symptoms
  • Minimal or no side effects
  • No uncontrollable craving for opioid agonists

❑ Begin with buprenorphine/naloxone combination, increasing dose by 2/0.5-4/1 mg per week till stabilization is achieved, most stabilizing at 16/4-24/6 mg}
❑ As patient stabilizes, transition to alternate day or every third day regimen by doubling and tripling daily doses respectively


Maintenance phase:
❑ Maintain at same dose as daily stabilization dose
❑ Decide total treatment duration based on:

  • Stable housing & income
  • Patients motivation, doctors comfort in tapering
  • Presence of psychosocial support
  • Absence of legal support
  • Other drugs & alcohol abuse