Exploring Slow Release Oral Morphine (SROM) As a Transition Bridge for Medium to High Doses of Methadone Conversion to Buprenorphine/Naloxone Sublingual: A Calgary Concept and Approach
Bibliographic record
Abstract
ABSTRACTRésumé Introduction: Buprenorphine/naloxone sublingual (SL) has recently become the first-line treatment in the management of opioid use disorder. Due to a legacy effect, numerous individuals have been on methadone for an extended period of time, on high doses, and are hesitant to try buprenorphine/naloxone SL due to difficulties in getting into adequate withdrawal for induction due to methadone's prolonged half-life. Case presentation: We present 2 cases in which slow release oral morphine was utilized to help convert individuals successfully from methadone to buprenorphine/naloxone SL. Management and outcomes: Patients were successfully transitioned with minimal withdrawal concerns, cravings, and adverse effects. Discussion: The Calgary slow release oral morphine transition approach presented herein provides a novel, relevant, and reliable way to transition patients from high dose methadone to buprenorphine/naloxone SL in an outpatient setting. Introduction: La buprénorphine / naloxone sublinguale (SL) est récemment devenue le traitement de première ligne dans la gestion des troubles de la consommation d’opioïdes. En raison de l’effet de conséquence, de nombreuses personnes ayant pris de la méthadone pendant une période prolongée, à des doses élevées, hésitent à essayer la buprénorphine / naloxone SL en raison de la difficulté d’obtenir un sevrage adéquat pour l’induction en raison de l’effet d’une utilisation prolongée de la méthadone. Présentation de cas: Nous présentons deux cas dans lesquels la morphine orale à libération prolongée (SROM) a été utilisée pour aider à sevrer avec succès des individus de la méthadone en buprénorphine / naloxone SL. Gestion et résultats: Les patients ont réussi la transition avec des problèmes légers de sevrage, d’envies et autres effets indésirables minimes. Discussion: L’approche de transition SROM de Calgary ici présentée offre un moyen novateur, pertinent et fiable pour aider les patients à faire la transition de la méthadone à forte dose à la buprénorphine / naloxone SL en consultation externe.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".