Minimum time following most recent opioid exposure to introducing buprenorphine in adolescents

Opioid	Minimum time to introduce buprenorphine from last opioid exposure (hours)
Short-acting (eg, heroin, oxycodone)	12
Fentanyl^[1]	24 to 48^*
Methadone	48 to 72

These times are a general guideline to help decrease the risk of precipitated withdrawal.

* If use of illicitly manufactured opioids, it is prudent to presume that all opioid exposures include fentanyl due to widespread adulteration.

Reference:

Varshneya NB, Thakrar AP, Hobelmann JG, Dunn KE, Huhn AS. Evidence of buprenorphine-precipitated withdrawal in persons who use fentanyl. J Addict Med 2022; 16:e265.

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