The National Alliance of Advocates
for Buprenorphine Treatment

Buprenorphine (Suboxone^®, Subutex^®3, Zubsolv^®4, Bunavail^™5, Probuphine^®6) is an opioid medication used to treat opioid addiction in the privacy of a physician's office.¹ Buprenorphine can be dispensed for take-home use, by prescription.¹ This, in addition to the pharmacological and safety profile of buprenorphine, makes it an attractive treatment for patients addicted to opioids.²

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Opiates/Opioids

Opiates are drugs derived from opium. At one time "opioids" referred to synthetic opiates only (drugs created to emulate opium, however different chemically). Now the term Opioid is used for the entire family of opiates including natural, synthetic and semi-synthetic. Medical professionals use the word opioid to refer to most opioids, and opiate for a specific non-synthetic opioid; however, many only use “opioid”. Consistent with the newest definition, this website uses “opioid” to refer to all opioids and opiates.

An opioid is any agent that binds to opioid receptors(protein molecules located on the membranes of some nerve cells) found principally in the central nervous system and gastrointestinal tract, and elicits a response. There are four broad classes of opioids:

• Endogenous opioid, naturally produced in the body, endorphins
• Opium alkaloids, such as morphine and codeine
• Semi-synthetic opioids such as heroin,oxycodone, and Buprenorphine
• Fully synthetic opioids, such as methadone, that have structures unrelated to the opium alkaloids

Examples of opioids are: painkillers such as morphine, methadone, Buprenorphine, hydrocodone, and oxycodone. Heroin is also an opioid and is illegal.

Opioid drugs sold under brand names include: OxyContin® , Percocet® , Vicodin® , Percodan® , Tylox® and Demerol® among others.

Opioids attach to receptors in the brain. Normally these opioids are the endogenous variety created naturally in the body. Once attached, they send signals to the brain of the “opioid effect” which blocks pain, slows breathing, and has a general calming and anti-depressing effect. The body cannot produce enough natural opioids to stop severe or chronic pain nor can it produce enough to cause an overdose.

To understand the appeal of opioids it is necessary to understand the effects. At low to moderate doses the “High” from opioids is not intoxication or impairing (as with alcohol). It does not feel like alcohol or marijuana, or hallucinogens. It instead provides feelings of intense joy and comfort, more so than can be obtained naturally. It is similar to feelings of great accomplishment, or achievement of a lifetime goal, rather than an impairment.

At higher doses, breathing is slowed, eventually to the point of death. This respiratory depression is the cause of overdose deaths. It can be especially dangerous when opioids are taken with other drugs that also slow breathing such as Xanax (alprozolam) which is a central nervous system (CNS) depressant. When these drugs are combined, so is the effect of slowed breathing, adding their respiratory depressive effects together. A non-lethal dose of both taken together can be fatal. With opioids there is a small window between euphoria and death.

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