The medical evidence for any form of maintenance therapy for opioid addiction is very strong. The success rates for methadone are about 60-70 percent and buprenorphine are 70-80 percent. Which one to choose is an excellent question. WHAT’S THE DIFFERENCE? Methadone is a long-acting mu opioid analog. Buprenorphine is a partial mu opioid agonist with a high receptor afnity and occupancy - 93 percent at 16 mg a day (also the Morse Clinics’ maximum dose). Both create a blockade or attenuated effect of the use of additional opioids with buprenorphine having greater blockade. They essentially stop you from getting high. Buprenorphine has a favorable safety prole due to a ceiling effect (you cannot overdose on buprenorphine alone – unlike methadone). Buprenorphine has lower street value and lower abuse potential – folks who suffer with opioid addiction cannot get high on opioids while on buprenorphine.
BY ERIC D. MORSE, MD THIS ARTICLE WAS ORIGINALLY A BLOG POST
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