Posted on 18 May, 2018
Buprenorphine is the molecule in common to all the forms of substitution treatment of opioid addiction. It has replaced Methadone as the gold standard. It is a partial agonist of the opioids. It has about 25 per cent of opioid activity which is enough to eliminate the opiod cravings and almost as important re-establish the mood that was previous to the opioid use.
Buprenorphine has an activity ceiling, so the risk of overdosing with buprenorphine is minimal with the exception of children or opioid naive adults, those that have never used opioids. Buprenorphine is an antagonist of opiods through competition for the receptor: the affinity of buprenorphine for the opioid receptors is higher than the affinity of other opioids so it displaces the opiod molecules from the place where they exert their activity, inducing a precipitated withdrawal.
Subutex is the commercial brand name of buprenorphine, it is the original substance. Suboxone is a combination of Buprenorphine and an antagonist of the opiods called naloxone, the active principle of Narcan. The appropriateness mixing Buprenorphine with naloxone, is widely challenged. In other areas of this blog we will review the controversy in detail.