Reading the ledger: the episode is an educational synthesis, not a protocol. Dose, timing, withdrawal, and evidence-strength claims should be checked against the source itself and current local policy.
Professional-society guideline · 2020ASAM National Practice Guideline, 2020 Focused Update.Conventional transfer, low-dose methadone range, withdrawal-based initiation, and monitoring considerations. Open source ↗
Federal treatment-improvement protocol · 2021 / page updated 2024SAMHSA TIP 63: Medications for Opioid Use Disorder.Treatment planning, medication choice, continuity, counseling, and conventional methadone-transfer context. Open source ↗
FDA-approved product labelingBuprenorphine Sublingual Tablets prescribing information, DailyMed.Highest-priority safety language on objective withdrawal, timing, and precipitated or prolonged withdrawal risk. Open source ↗
FDA label · 2025Methadone hydrochloride prescribing information.Variable distribution and terminal half-life help explain why a fixed waiting interval cannot replace clinical assessment. Open source ↗
Clinical considerations · ASAM · 2023Buprenorphine Treatment for Individuals Using High-Potency Synthetic Opioids.Places standard, high-dose, and low-dose initiation concepts in context; does not establish one universal methadone-transfer recipe. Open source ↗
Systematic review · 2025Adams, Waters, Sobieraj. Initiating buprenorphine to treat opioid use disorder without prerequisite withdrawal: an updated systematic review.Evidence grading for low-dose initiation; heterogeneous, largely uncontrolled evidence does not establish superiority over conventional transfer. Open source ↗
Systematic review · 2022Lintzeris et al. Strategies for Transfer From Methadone to Buprenorphine.Direct transfer evidence, protocol heterogeneity, and limits of the older evidence base. Open source ↗