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 10 ng/mL and 5 ng/mL in saliva.
