Precipitaded Withdrawals

[crizzle]

yes i know, swim is full of questions today.

i was wondering why precipitated wds occur when taking subs too soon after your DOC. i know the naloxone or bupe knocks everything off the receptors, but then doesnt the bupe just do its job and fill them nicely? i dont get it....

[Dickon]

The answer, as far as I understand it, is that opiates, partial agonists, and antagonists all bind to the receptor sites. The difference is that agonists stimulate the receptors a lot, partial agonists stimulate the receptors a little bit, and antagonists don't stimulate the receptors at all (and prevent endorphins binding to the receptors too). The "stickiness" of an agonist/antagonist/partial agonist is called its binding affinity. Thus saying that buprenorphine has a higher binding affinity than heroin, say, means that the buprenorphine molecules will knock the heroin molecules off the receptors. So, the precipitated withdrawal is caused when the body is used to lots of heroin molecules sticking to the receptors and fully stimulating them being replaced by "stickier" buprenorphine molecules, that only partially stimulate the receptors. Thus, the total stimulation of the opiate receptors (specifically the mu receptors I believe) is dramatically and swiftly reduced. The result: withdrawal. This explains why buprenorphine will act pretty much like an opiate (agonist) in someone with no tolerance. Here the partial stimulation of the receptors is similar to the full stimulation of a full agonist.

I hope that makes things a little clearer

Dickon

Reputation Comments on this post:

great explanation... thanks

[crizzle]

thanks I appreciate it.
Now, only if swim could find a way to get high while on subs without having to start withdrawal again........