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Buprenorphine


A prescription medication for people addicted to heroin or other opiates that acts by relieving the symptoms of opiate withdrawal such as agitation, nausea and insomnia. Buprenorphine is more weakly addictive and has a lower risk of overdose than methadone. The effects last for about three days.

Street names

  • Bupe, Subs, Subbies, Orange guys

Methods of abuse

Buprenorphine or buprenorphine hydrochloride can be administered via intravenous or intramuscular injection, transdermally with a patch, or in the form of a sublingual tablet. The average elimination half-life of buprenorphine is 37 hours. Many addicts have learned they can use the medication, not to treat their addiction, but to maintain it. Suboxone won’t get them “high” but it will help them smooth out withdrawal symptoms between highs. Suboxone is so popular with addicts that it has turned into a street drug – to be bartered or exchanged for money, heroin or other illegal drugs. According to one estimate, about half of the buprenorphine obtained through legitimate prescriptions is either being diverted or used illicitly.

Mental effects

Opioids attach to receptors in the brain, with three main effects; reduced respiration, euphoria, decreased pain. The more opioids ingested the more of an effect. The process of opioids binding to the opioid receptors can be thought of as a mechanical union, the better the fit the more the opioid effect. Buprenorphine is different. It too binds to the receptors, however, without a perfect fit. As a result the Buprenorphine tends to occupy the receptors without all of the opioid effects. The receptor is tricked into thinking it has been satisfied with opioids without producing strong feelings of euphoria, and without causing significant respiratory depression. This, in turn, prevents that receptor from joining with full opioids; therefore if the individual uses heroin or painkillers, they are unlikely to experience additional effect. Buprenorphine tends to stay with the receptors, blocking them, much longer then opioids do.

Physical effects

Buprenorphine has a very high binding affinity to the mu-opioid receptor; however, due to the fact that it is only a partial opioid agonist, it does not produce the same "high" or "rush" of full agonists (morphine, oxycodone, heroin). These two properties must be carefully considered in any given situation for two reasons. Most importantly, the long half-life and high binding affinity can complicate situations involving overdosage. For individuals dependent on fullagonist opioids, if there is not sufficient time between the last dose of the full-agonist and the dosing of buprenorphine, it can trigger precipitated withdrawal.

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