Posted by MB on February 15, 2004, at 12:46:02
In reply to Buprenorphine side affects « sbaartman, posted by Dr. Bob on January 28, 2004, at 18:47:16
Buprenorphine is a partial agonist. Here's an analogy: think of the mu opiate receptor (the one that gets you high) as a door. Heroin, codeine, morphine, oxy, etc. are all *full* agonists. Think of them as holding the door ALL THE WAY open. This will make you feel good. OK, now think of the buprenorphine (the partial agonist) as forcing the door to the half-open position.
So...if you are currently using a full agonist, and the door is all the way open, and you introduce buprenorphine, that door is going to become halfway shut and you'll be thrown into withdrawal: instant cluck. Now, suppose you've quit the full agonist (heroin, oxy, etc.) and you're already sick. That means that door is slammed shut. At this point, adding buprenorphine will open that door half way and make you feel better.
Buprenorphine to a "well" addict = instant cluck.
Buprenorphine to a kicking addict = relief.
Buprenorphine to someone who has not been using = mild high.In treatment, I saw a patient come in who had fixed right before getting there. He was feeling quite well. The doc gave him a Subutex (sublingual buprenorphine) tab right away, and before it was halfway dissolved the guy puked all over the docs shoes. The damn bupe threw him into a cluck, but by the time the heroin was out of his system, he was sure glad he had the bupe: he felt fine. And for him, the bupe withdrawal was cake.
MB
poster:MB
thread:306607
URL: http://www.dr-bob.org/babble/subs/20040130/msgs/313604.html