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Re: buprenorphine

Posted by Elizabeth on April 14, 2000, at 1:56:52

In reply to Re: buprenorphine , posted by Cam W. on April 11, 2000, at 19:07:25

I've taken buprenorphine and also morphine but not fentanyl. What would you like to know?

Cam made some comments that I can add to:

> Nigel - Buprenorphine is not used in Canada and I really do not know much about it. I think it is a synthetic opiate being tried in combination with naltrexone for treating opiate addiction (in France).

It can't be used with naltrexone; it wouldn't work. (If you add naltrexone to it, you might experience opioid withdrawal symptoms, as well.)

> Studies have shown that it doesn't work as good in maintenance therapy as methadone.

There's an issue about this in the U.S. in regard to tolerability and compliance: people taking methadone for addiction treatment have to get it from special clinics, whereas buprenorphine could be prescribed in a doctor's office. (Methadone can be prescribed in a doctor's office for other indications, e.g. pain.)

> By itself, it was supposed to elicit euphoria like morphine.

Not really, no. Some people find it euphoric when injected, but I suspect it's more on a level with codeine, not morphine.

> Also, in combination with benzodiazepines it has caused respiratory depression and death in a number of people in Europe.

I think if you read up on that you'll find that all the deaths in question resulted from massive doses of benzos -- the amounts used by benzo abusers, not by anxiety patients. (I will also say that the one time I tried Ambien with Buprenex, it packed quite a bit more punch than it does normally.)

> Also, both fluvoxamine and fluoxetine inhibit it's metabolism.

Not fluoxetine so much. I'm not sure if the interaction is clinically significant, anyway. Do you happen to know?

> The above I gleaned from abstracts on MEDLINE, but other than that, I really don't know what it is good for. - Cam W.

It's an antidepressant opioid that has relatively less abuse potential than other opioids.


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