YSM Issue 87.4

symptoms and receive therapy and assistance
from physicians—but recovery still isn’t easy.
It’s all too tempting for addicted patients to
put a stop to these symptoms by returning to
the illicit drugs.
The solution? Help the body stop those
withdrawal symptoms so that the patient can
recover without the temptation of returning
to illegal drugs. “To give the old analogy,
it’s sort of a lock and key,” Greenwald said.
The buprenorphine drug binds to the same
receptors that were previously filled by the
opioid particles. In doing so, buprenorphine
performs similarly to how an illegal opioid
would in the body. This reduces the severity
of the withdrawal symptoms that the patient
experiences. The more opioid-hungry
receptors the buprenorphine occupies, the
less craving the recovering addict has for the
illegal drugs.
“What we try and do with [buprenorphine]
is to reduce the availability of those
receptors,” Greenwald said. “It will provide a
safer replacement that helps start the person
on the right track.”
A Scientific Call to Action
Greenwald and his team found that in
order to be effective against withdrawal
symptoms, buprenorphine had to be able
to occupy at least half of the receptors that
would otherwise be craving opioids. “Higher
doses are generally demonstrated to produce
greater reductions in illegal opioid use,”
Greenwald said.
addiction
FOCUS
But here’s the problem: the question of
how much buprenorphine each patient
ought to receive doesn’t have a one-sizefits-all
answer. Individual patients may
require different amounts of buprenorphine
to block enough receptors in order to
adequately ease their withdrawal symptoms.
And buprenorphine is often used as just one
component of a multi-faceted treatment
approach, which may also include therapy
or treatment for other psychiatric problems.
Even patients’ environments—whether
their peers are using or encouraging them to
return to opioid use—can impact their odds
of successful recovery.
Clinicians have to toe a fine line in
deciding how much buprenorphine to
provide to patients. Recovering addicts need
ART BY ANNALISA LEINBACH
Buprenorphine provides a solution for recovering addicts by mitigating withdrawal symptoms so that the patient can
recover without the temptation of relapse. However, the question of how much buprenorphine to prescribe doesn’t
have a one-size-fits-all answer.
www.yalescientific.org
October 2014
Yale Scientific Magazine
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