“…heroin, methadone) from the receptors, without full activation (partial agonism), leading to a 'precipitated' opioid withdrawal [3,4]. Precipitated opioid withdrawal is characterised by the rapid onset of opioid withdrawal symptoms (such as aches, nausea and vomiting, diarrhoea and abdominal cramps, dilated pupils, running nose, yawning) within 1-2 h following the first dose of buprenorphine, and gradually subsiding over the subsequent 6-24 h. This is a well-recognised adverse outcome from buprenorphine induction [3][4][5], and was found to occur in 9% of buprenorphine inductions [6]. Risk factors for precipitated withdrawal include transferring from long-acting agents such as methadone, recent benzodiazepine use, no past patient experience with buprenorphine, and a low initial dose of buprenorphine/naloxone [6].…”