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Buprenorphine

Buprenorphine is a semisynthetic opioid analgesic derived from thebain, a component of opium. It has a longer duration of action than morphine when indicated for the treatment of moderate to severe pain, peri-operative analgesia, and opioid dependence. Low dose buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. Buprenorphine carries a lower risk of abuse, addiction, and side effects compared to full opioid agonists because of the “ceiling effect,” whereby increased doses of the drug do not produce increased effects after a certain point, or ceiling. However, it has also been shown that buprenorphine has abuse potential and may itself cause dependency. Subutex®, and a buprenorphine/Naloxone combination product, Suboxone®, are the only two forms of buprenorphine that have been approved by FDA in 2002 for use in opioid addiction treatment. Buprenorphine was rescheduled from Schedule V to Schedule III drug just before FDA approval of Suboxone and Subutex.

DrugCheck® drug of abuse tests yield a positive result when the concentration of buprenorphine in urine exceeds 5 ng/mL* or 10 ng/mL, and 5 ng/mL* in saliva.

* Forensic use only

Drug Abuse Recognition (DAR)

As a point of reference, the following objective symptoms: Horizontal Gaze Nystagmus, Vertical Gaze Nystagmus, Lack of Convergence, Pulse, Romberg Stand, Pupil Size, and Pupillary Reaction To Light are determined during a DAR evaluation to identify drug influence and impairment. The following objective symptoms of someone under the influence of buprenorphine may be used as a reference only, and should not be used to replace certified Drug Abuse Recognition Training.

Please contact Express Diagnostics if you would like more information on DAR-OS or drug abuse recognition training.

Opiates: Buprenorphine, opiates, methadone, oxycodone, tramadol, fentanyl

Horizontal Gaze NystagmusNot Present
Vertical Gaze NystagmusNot Present
Lack of ConvergenceNot Present
PulseSlow
Romberg StandSlow
Pupil SizeConstricted
Pupillary Reaction To LightSlow

Source: Graves & Associates