Buprenorphine (Subutex®)

Like all opiates, buprenorphine has analgesic and cough-irritant effects. However, its euphoric and sedative properties are less pronounced than those of other opioids, which is why it is also used for substitution treatment. Buprenorphine is a partial agonist. This means that, for safety reasons, only a submaximal effect is elicited. After a certain dose, a saturation effect (ceiling effect) occurs, which prevents a further increase in the effect. This makes the active ingredient so relevant for substitution treatments, as withdrawal symptoms can be alleviated and overdoses avoided.

Onset of effect

swallowed: after 60-90 minutes
via skin (patch): 4-12 hours

Duration of action

approx. 12-72 hours

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0.4-0.8 mg, max. 2 mg/day

From 16 mg, the saturation effect (ceiling effect) comes into effect and no more effect enhancement is felt. When consuming for the first time, low doses should be used, as the risk of respiratory arrest is increased.

Appearances

As infusion solution (emergency medicine), melting tablets and patches. For abusive use also smoked or snorted.

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Mixing with other downers (alcohol, benzodiazepines, drugs, GHB/GBL, heroin, opioids) can lead to dangerous interactions and an intensification of the effect and there is a risk of respiratory depression up to respiratory paralysis, a drop in blood pressure, a coma and in the worst case can lead to death!

The combination with methoxetamine (MXE, Metha-Keta) increases the opioid effect.

Mixing opioids with DXM is generally not recommended - there is an increased risk of central nervous system disorders as well as heart and respiratory problems. In addition, DXM lowers the individual opioid tolerance, which is why the risk of overdose increases considerably.

Mixed use of opioids with stimulants (such as cocaine, amphetamine, methamphetamine) puts extreme strain on the body and the cardiovascular system. The effects can mask each other, so that they are subjectively felt to be weaker. If the effect of the stimulants wears off before the opioids, there is a risk of delayed overdose and even respiratory depression.

Opioids are highly effective medications that should only be used for a limited time and, at best, with a doctor's supervision.

Start with a low dose and wait for the effect and tolerance before adding more.

After a period of abstinence, use a much lower dose! The usual dose before the abstinence phase can otherwise quickly have life-threatening consequences.

If you inject opioids, dose even more carefully, as the range between desired effect (rush) and dangerous overdose is even more difficult to assess. Avoid injecting opioids; the risk of overdose is particularly high. Always use new (clean and sterile) injection material! Never exchange syringes, filters, water, disinfection swabs to avoid transmission of hepatitis and HIV.

Do not rely on dosage information from colleagues who regularly use opioids. Due to habituation or dependence, their doses are significantly higher and can be fatal for new users.

Take longer breaks (at least several days) between consumption.

Refrain from citrus fruits (especially grapefruit) before or during consumption. The combination can lead to an increase in the effect of the opiate and/or respiratory depression.