The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update¶
American Society of Addiction Medicine. (2020). The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update: 2020 Focused Update.
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Domain-specific¶
- Partial Agonist
- Its high affinity also means that if given to a patient with recent full-agonist opioid on board, buprenorphine displaces the fuller drug from the receptors and substitutes its own lower activation, which can trigger precipitated withdrawal — the reason induction is timed to begin only once the patient is already in mild withdrawal
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“Buprenorphine has a higher affinity for the mu-opioid receptor compared to most full opioid agonists. Because buprenorphine is a partial mu-agonist, the risk of overdose during buprenorphine initiation is low. However, buprenorphine will displace full agonists from the receptor with resultant reduction in opioid effects.”
- Its high affinity also means that if given to a patient with recent full-agonist opioid on board, buprenorphine displaces the fuller drug from the receptors and substitutes its own lower activation, which can trigger precipitated withdrawal — the reason induction is timed to begin only once the patient is already in mild withdrawal
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