Synthetic Opioids: Methadone, Buprenorphine
Methadone and Buprenorphine
These two synthetic opioids were primarily developed as analgesics and for treatment of chronic pain. Being opioids they influence the human body producing drowsiness, vomiting and respiratory depression which might be advantageous for the treatment of patients who suffer chronic pain relieving the symptoms and allowing them to resume a normal life. These drugs are now prescribed by physicians as treatment for clinical depression for both in-patient and out-patient treatment but being restricted are governed by laws and control methods required by the FDA. We now discuss both briefly to show their effects and uses below to better understand them in cases such as addiction and dependency.
Methadone/dolophine is a synthetic opioid that is generally used as an analgesic and used as a treatment of narcotic addiction. It has a slower metabolism factor and very high lipid solubility that makes it longer lasting than Morphine-based drugs. It has a half-life of 15 to 60 hours and in some cases have reached 190 hours. It’s analgesic properties are however shorter that makes administration of multiple-doses necessary. It’s abuse has been attributed to have an effect of decreasing dependence on opiates but its effects as an effective treatment for addiction are widely debated for it is determined to serve as a substitute for either morphine or opiate dependency as determined by the Cochrane review of 2004. It should also be noted that overdosing can have very grave side effects and has been attributed to several deaths. Even the highly controversial deaths of a top model-actor and his son have been attributed to the lethal properties of it’s abuse thus debate on it’s effectiveness and prescription value as treatment for chronic pain and drug addiction is under way.
Buprenorphine, is also an opioid drug that has been developed for the treatment of chronic pain disorders and as a treatment for opiate addiction similar to Methadone. Unfortunately, like methadone it’s effects have given popularity to it’s abuse due to opiate psychological effects. Its effects include drowsiness; vomiting and respiratory depression which when combined with the effects of anti-depressants that influences the central nervous system can cause death. Buprenorphine is a thebaine derivative and similar to methadone has great analgesic potential when applied as treatment for chronic pain. It’s half life is from 20 to 73 hours with a mean average of 37. It is considered more effective when administered through a sub-lingual tablet which can have effects lasting 6 to 8 hours. It is ideal as an alternative treatment for addiction for it has the potential to precipitate withdrawal symptoms in people who are dependent on other forms of opioids. It also has the ability to develop dependence if abused but the effects are seen as more favorable than methadone. It is also prescribed as treatment for depression and has been attributed to successful recovery in patients that have participated in clinical trials. But being an opioid, it is still considered as a restricted drug and strict regulatory checks are in place. Doctors can and do prescribe the drug as medication but being prescribed for a psychological disorder which has to be determined through consultation with several independent practitioners that makes prescription fall into a “grey zone”. This is an area where the reason for dispensing is not thoroughly defined and has not been fully understood by the respective government branches of the DHHS. Excessive prescription of restricted drugs are subject to review and can carry penalties from fines, license revocation and incarceration in the event of conviction through court proceedings.
Both these drugs are used for both shot and long-term opioid maintenance therapy and when both are compared side by side both have advantages and disadvantages. In terms of efficacy high dose Buprenorphine has been found to be significantly superior to low dose methadone administration. It also has a high non-dependency index that allows users being treated with the drug for addiction less adverse effects when the cessation of treatment concludes treatment as a success. Built in receptor antagonists prevents the abuse of the drug and induces withdrawal symptoms but Buprenorphine’s stronger ability to bind against brain receptors has raised the debate on areas of detoxification and treatment for longer periods. Both substances block the effects of other opioids and can have serious effects if used in conjunction with other medication for depression.
These drugs can easily be tested using simple urine test kits that detect specific drugs that are commonly abused. These test kits are accurate and need little expertise with respect to use and interpretation. As with other drug detection techniques methadone and Buprenorphine are detected using immunoassaying where the metabolite levels are detected by specific antigens that first detect the presence then indicate the respective drug in use. They are similar or even combined with multiple testing kits that can detect up to ten different substances that are now categorized as abused by addicted individuals.
These tests provide easy detection and interpretation allowing the prescription of the proper treatment and consultation with SANHSA treatment facilities that are located nationwide. Detection is necessary due to the adverse side effects when compounded with other treatments being received such as anti-depressants and other medication for ADHD and other psychological disorders.
These kits can be purchased on-line as drug specific or batch testing kits, with drug specific testing being designed to test only for one type of drug. Kits can cost from a little more than $10.00 to premium ones that cost more than twice that amount. This brings screening to manageable and cost effective levels that are within reach of ordinary households, schools and companies. To assure quality and accuracy, one must check if the product being used is accredited or approved by the FDA and SAMHSA which can be accomplished by searching for the specific device in its database.
If for use in legal cases these test kits are to be evaluated further by laboratory analysis using methods specified by the Federal Government and SAMHSA that laid out the guidelines and methods by which they are carried out. These measures were put in place and are constantly revised according to the changes that arise in society and allow the treatment process to progress at suitable speed that could vary from individual to individual.
