Buprenorphine Implementation Toolkit

How buprenorphine works

Randy Brown, MD, PhD, is Associate Professor in the University of Wisconsin School of Medicine, Department of Family Medicine and Public Health. He specializes in addiction medicine and is also a certified buprenorphine prescriber. He describes buprenorphine in the 2-minute video above.

Buprenorphine defined

The National Alliance of Advocates for Buprenorphine Treatment describes buprenorphine as follows:

"Buprenorphine ('bu-pre-'nôr-feen) (C29H41NO4) is a semi-synthetic opioid derived from thebaine, an alkaloid of the poppy Papaver somniferum. Buprenorphine is an opioid partial agonist. This means that, although buprenorphine is an opioid, and thus can produce typical opioid effects and side effects such as euphoria and respiratory depression, its maximal effects are less than those of full agonists like heroin and methadone. At low doses buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms."

Full opioid agonist vs. partial opioid agonist

Full opioid agonists signal the opioid receptors in the brain to stimulate and release a flood of endorphins. This rush of endorphins produces intense feelings of euphoria. Oxycodone, methadone, codeine, heroin, and morphine are some of the most widely misused full opioid agonists.

As a partial opioid agonist, buprenorphine triggers the opioid receptors in the brain to release a much smaller quantity of endorphins. Buprenorphine acts on the same opioid receptors in the brain as the full opioid agonists, but produces a less intense “high.