How is buprenorphine different from other opioids used for maintenance, such as methadone, dihydrocodeine, or heroin?
Methadone, morphine, heroin and dihydrocodeine can all be substituted for each other in treating withdrawal and dependence. Buprenorphine, however, generally can be started only with patients who have a fairly low level of dependency (“habit”). This is because buprenorphine has both agonist and antagonist effects, and therefore can cause opioid withdrawal (‘dopesickness’) if it is given to someone who is dependent on other opioids.
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