Buprenorphine Subutex

Buprenorphine is an opioid with mixed agonist-antagonist properties that may be abused or used as an alternative to methadone in detoxification from opiates (21). It is taken sublingually, and self-administration of the drug in the custodial environment must be personally supervised by the doctor who should observe the patient for 5 min to ensure that the drug has fully dissolved (22). An unusual property of buprenorphine is that after chronic administration the onset of the abstinence syndrome is delayed. Heroin addicts who are dependent on a small dose of opiate can be transferred onto buprenorphine, which can be withdrawn fairly easily because of the delayed onset of the abstinence

Half-Lives and Observation Times Required After Acute Narcotic Overdose

Duration of action

Observation

Opioid

via iv route

t 1/2

time

Methadone

May be days

15-72

24-36

(Dolophine, Amidone)

Morphine

Usually 2-4 h

3

6

Heroin

Usually 2-4 h

v. short

6

Codeine

2-4 h (oral)

3

6

Note: Generally, if a patient remains asymptomatic 6 hours after the administration of naloxone they may be discharged. From ref. 23a.

Note: Generally, if a patient remains asymptomatic 6 hours after the administration of naloxone they may be discharged. From ref. 23a.

syndrome. However, if it is given to an individual dependent on large doses of opiates, the antagonist properties precipitate withdrawal symptoms (23).

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