Buprenorphine (subutex): less is more
di Albert0
il 12 May 2007 05:22:02 -0700
newsgroups it.discussioni.droghe
message-id <1178972521.956620.106950@u30g2000hsc.googlegroups.com>
Because of the pharmacology of buprenorphine (Suboxone®, Subutex®,
Buprenex®), you
really can't "taper" like you would with straight opioid agonists.
This drug has a lot
of very complicated properties, and doesn't behave much like a typical
opioid at all.
For one thing, it has a "nonlinear dose/response curve." This means
that, instead of
the effect increasing as you increase the dose, the effect increases
as you increase
the dose up to a modest level, but then it levels off and further
increases don't
produce any more effect. Then, at high doses, the curve actually
turns down as the
drug begins to antagonize itself the more you increase the dose.
The usual doses of 16 or 32 mg/day, IMO, are insanely high, and
actually negate the whole value of the drug. You should always try to
use as little buprenorphine as possible, keeping in mindthat, because
of its complex pharmacodynamics, less really is more ... a *lot* more.
If you get on the right dose (which I think lies between 4 and 8 mg),
you should be
able to just stop it and after a week or so you are without any kind
of withdrawal effects
occuring. Anyway, the idea of tapering bupe doesn't make a lot of
sense. People try to taper
because they're starting from doses that are much too high.
The other thing is that buprenorphine is only useful if your tolerance
is
below the equivalent of 30 mg methdone. If you're on an amount of
dope that's
equivalent to more than that, you run the risk of kicking off an
unbelieveably intense
precipitated withdrawal, which is the closest thing to Hell that a
human being can
experience.
Risposte
Tutti i messaggi della discussione