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Buprenorphine (Subutex, Britoflex, Lofexdine, Naltrexone)

BuprenorphineSCIENTIFIC TERM:

17-(cyclopropylmethyl)-alpha-(1,1-dimethylethyl)-4,5-epoxy- 18,19-dihydro-3-hydroxy-6-methoxy-alpha-methyl-6,14- ethenomorphinan-7-methanol

STREET NAMES:

Bupe, subs, subbies, orange guys

EFFECTS:

These are a semi-synthetic opiate (the term opiate describes any of the narcotic opioid alkaloids found as natural products in the opium poppy plant).  If you stop taking heroin, they can prevent or reduce the unpleasant withdrawal symptoms. Many people stay on them long-term, but some people gradually reduce the dose and come off drugs altogether. You should not take any street drugs or much alcohol when you are taking these.  If you take these, you are unlikely to get withdrawal symptoms if you stop heroin (or the withdrawal symptoms are much less severe). 

DRUG FORM & METHOD OF USE:

These are a tablet which you put under the tongue. The tablet dissolves over 3-7 minutes and is absorbed straight into the bloodstream from the mouth. (The tablets do not work if you swallow them into the stomach).   Because of its opioid agonist effects, these opiates are abusable, particularly by individuals who are not physically addicted to opioids

HEALTH RISKS (long term) which includes withdrawal & tolerance:

These are an opioid partial agonist. This means that, although these are opioids, and thus can produce typical opioid agonist effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone. At low doses they produce sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The agonist effects can increase linearly with increasing doses of the drug until at moderate doses they reach a plateau and no longer continue to increase with further increases in dose - the “ceiling effect.” Thus, these carry a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, in high doses and under certain circumstances,  these can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream.

LAW:

Many GPs will refer users to a community drug team to be assessed. Following assessment, the community drug team may prescribe these. Some GPs work in a 'shared care' arrangement and will prescribe whatever is recommended by a community drug team. Some GPs who are specially trained may assess and prescribe these without the need for referral.

  1. Buprenorphine was first marketed in the 1980s as an Analgesic (a remedy that relieves pain).
  2. Buprenorphine is also used recreationally, typically by opioid users. Users sometimes report a feeling of general well being, perhaps even to the point that they may become more outgoing or talkative.
  3. Due to the high potency of tablet forms of Buprenorphine, only a small amount of the drug need be ingested to achieve the desired effects.
  4. Buprenorphine is generally viewed to have a lower dependence-liability than methadone. In other words, withdrawal from Buprenorphine is less difficult.
  5. Using Buprenorphine improperly will increase your risk of serious side effects or death. Buprenorphine is a partial opiate-agonist (Opiate agonists encompass a group of naturally occurring, semi-synthetic, and synthetic drugs that stimulate opiate receptors and effectively relieve pain without producing loss of consciousness),   this is different to full opiate agonists (Heroin, Morphine, Methadone etc) in that it also has some of the properties of opiate antagonists such as Naltrexone (a substance that stops opiates binding to the receptors in your brain, used in overdoes etc).
  6. Buprenorphine is extremely long lasting, some patients can comfortably dose only every 3 days (as opposed to Heroin which lasts 4 - 8 hours). 
  7. Benzodiazapines or Barbituates should NOT be taken when taking Buprenorphine. This can lead to death (probably as they are both depressant).
  8. Overdose on Buprenorphine alone is uncommon, however it is possible to overdose on another opiate if the Buprenorphine is wearing off.
  9. From 1994 to 1998 in France, Buprenorphine was implicated in 1.4 times more deaths Methadone.
  10. Buprenorphine tablets are to be placed under the tongue and allowed to dissolve. Chewing or swallowing them will make them ineffective. Buprenorphine is sometimes injected, particularly when used as a substitute for street Heroin. Reports state that some addicts prefer injected Buprenorphine to low-quality street heroin. Dosages range from 4 to 32 milligrams per day for heroin dependence.
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