Buprenorphine: Considerations for Pain Management
Johnson RE, Fudala PJ, Payne R.
Department of Psychiatry and Behavioral Sciences,
Behavioral Pharmacology Research Unit (R.E.J.),
Johns Hopkins University School of Medicine,
Baltimore, Maryland;
Department of Psychiatry (P.J.F.)
and Behavioral Health Service (P.J.F.),
University of Pennsylvania School of Medicine,
VA Medical Center, Philadelphia, Pennsylvania;
Department of Neurology (R.P.),
Memorial Sloan-Kettering Cancer Center,
New York, New York, USA.
J Pain Symptom Manage. 2005 Mar;29(3):297-326


New effective analgesics are needed for the treatment of pain. Buprenorphine, a partial mu-opioid agonist which has been in clinical use for over 25 years, has been found to be amenable to new formulation technology based on its physiochemical and pharmacological profile. Buprenorphine is marketed as parenteral, sublingual, and transdermal formulations. Unlike full mu-opioid agonists, at higher doses, buprenorphine's physiological and subjective effects, including euphoria, reach a plateau. This ceiling may limit the abuse potential and may result in a wider safety margin. Buprenorphine has been used for the treatment of acute and chronic pain, as a supplement to anesthesia, and for behavioral and psychiatric disorders including treatment for opioid addiction. Prolonged use of buprenorphine can result in physical dependence. However, withdrawal symptoms appear to be mild to moderate in intensity compared with those of full mu agonists. Overdoses have primarily involved buprenorphine taken in combination with other central nervous system depressants.
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Opiates in psychiatry
Subutex and Suboxone
Opioids and depression
Buprenorphine and reward
Buprenorphine and naltrexone
Buprenorphine: the standard wisdom
Buprenorphine : behavioral pharmacology
Buprenorphine versus methadone or placebo