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plenty of people successfully use buprenorphine to taper off heroin. some people do end up going on long term buprenorphine maintenance, but the harm there is r

plenty of people successfully use buprenorphine to taper off heroin. some people do end up going on long term buprenorphine maintenance, but the harm there is radically less than an active oxy/heroin addiction. even in the worst case scenario, any day that an opioid addict takes buprenorphine is a day where they have far less risk of fatal overdose.

stochastic_monk 8y ago
Exactly. Additionally, methadone increases cardiac mortality by increasing the QT interval, so the drug with better efficacy and safety profile should fully replace it. Buprenorphine is good. And someone can’t get on it if they’re too addicted to opiates because as a partial agonist it can precipitate accelerated withdrawal, which acts as a protective mechanism, I imagine.
- mveety 8y ago
  Buprenorphine also increases cardiac mortality by increasing the QT interval. Buprenorphine is used over methadone mostly because its a partial agonist of the mu-opioid receptor which basically limits how high you can get.
  - stochastic_monk 8y ago
    You’re right! I hadn’t known that buprenorphine also caused it, but it seems all of the drugs used for that purpose. I did find a 2013 study stating that the effect was significantly less than that from methadone, but it’s good to know that both come with cardiac risks.
mveety 8y ago
I would disagree that buprenorphine is safer than oxycodone or pharmacologially pure heroin. Buprenorphine has more dangerous potential side effects than either of them, meaning it would be safer to use heroin or oxycodone. Also, the reduced risk of overdose isn't because of the drug, it's because the user isn't dosing it themselves.
- drooogs 8y ago
  > Buprenorphine has more dangerous potential side effects than either of them genuinely curious, what are these? > the reduced risk of overdose isn't because of the drug it is significantly harder to overdose on buprenorphine, especially in formulations that contain naloxone.
  - pharrington 8y ago
    Well, the answer to this particular unasked riddle is to just administer the naloxone.
    - drooogs 8y ago
      works great unless the person is alone. then they die.
superkuh 8y ago
It also drastically decreases the likelyhood of potential harm from the government's use of violence in it's drug war. This is not an insignificant part of the danger of opioid use.

stochastic_monk 8y ago

Exactly. Additionally, methadone increases cardiac mortality by increasing the QT interval, so the drug with better efficacy and safety profile should fully replace it. Buprenorphine is good. And someone can’t get on it if they’re too addicted to opiates because as a partial agonist it can precipitate accelerated withdrawal, which acts as a protective mechanism, I imagine.

mveety 8y ago
Buprenorphine also increases cardiac mortality by increasing the QT interval. Buprenorphine is used over methadone mostly because its a partial agonist of the mu-opioid receptor which basically limits how high you can get.
- stochastic_monk 8y ago
  You’re right! I hadn’t known that buprenorphine also caused it, but it seems all of the drugs used for that purpose. I did find a 2013 study stating that the effect was significantly less than that from methadone, but it’s good to know that both come with cardiac risks.

mveety 8y ago

I would disagree that buprenorphine is safer than oxycodone or pharmacologially pure heroin. Buprenorphine has more dangerous potential side effects than either of them, meaning it would be safer to use heroin or oxycodone. Also, the reduced risk of overdose isn't because of the drug, it's because the user isn't dosing it themselves.

drooogs 8y ago
> Buprenorphine has more dangerous potential side effects than either of them genuinely curious, what are these? > the reduced risk of overdose isn't because of the drug it is significantly harder to overdose on buprenorphine, especially in formulations that contain naloxone.
- pharrington 8y ago
  Well, the answer to this particular unasked riddle is to just administer the naloxone.
  - drooogs 8y ago
    works great unless the person is alone. then they die.

superkuh 8y ago

It also drastically decreases the likelyhood of potential harm from the government's use of violence in it's drug war. This is not an insignificant part of the danger of opioid use.