How does Suboxone work in the brain?

Dr. Jeffry Junig explains here how buprenorphine (the main psychoactive ingredient in Suboxone) works in the brain.

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How Suboxone works in the brain

In the brain, buprenorphine molecules (the main ingredient in Suboxone) attaches to opioid receptors, which are molecules embedded in the surface of the receiving parts of certain brain cells (the molecules that bind to receptors are called ‘ligands’). Opioid receptors carry out certain actions when activated by any opiate or opioid, whether it is buprenorphine, pain pills, or heroin. But buprenorphine is unique from other opioids in that there is a ceiling to the drugs’ actions.

Once the blood level of buprenorphine is above a certain point, further increases in buprenorphine cause no greater effect on opioid pathways. The effect allows the blood level of buprenorphine to vary from dosing and metabolism of the drug, without causing a change in the activity of opioid pathways.

Finally, opioid pathways fire more rapidly during Suboxone use after receptors are activated. The pathways then activate a number of areas in the brain and spinal cord, with effects on pain sensation, mood, and a wide range of bodily functions.

About the author
Dr. Jeffrey Junig, MD, PhD is a psychiatrist practicing in northeast Wisconsin, in recovery from opioid dependence. He is Board Certified in both Psychiatry and Anesthesiology and holds a PhD in Neuroscience. He writes about buprenorphine at Suboxone Talk Zone, and manages a forum for patients taking buprenorphine called SuboxForum.
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