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Topic

Heroin

Methadone

Buprenorphine

Onset of action

 

A few seconds

30 minutes

30 to 40 minutes

Duration of action

 

4 to 6 hours

24 to 36 hours

About 24-48 hours

Route of administration

 

Injection, snorting, smoking

Oral

Sublingual

Frequency of administration

 

Several times a day

Daily or more frequently as needed

Every day or every other day

Effective dose

Ever increasing

Blocking dose, usually 80 to 120 mg

2 to 32 mg

Tolerance

 

Increasing tolerance

Tolerance is stable

Tolerance is stable

Euphoric effects

Euphoria for up to 2 hours

No euphoria when stabilized

No euphoria when stabilized

Overdose potential

High and increased

Rare – Potential if mixed with other depressants

Very rare

Overall safety

Potentially lethal

Very safe – Possibly associated with rare cardiac irregularities—Treatment choice in pregnancy

Overall good profile--Suboxone injection will cause serious withdrawal symptoms in dependent persons – Not recommended for use in pregnancy or breastfeeding—Caution with liver disease – Currently under study

Withdrawal

Within 3 to 4 hours after last dose

Within 24 hours after last dose

Within 36 to 48 hours after last dose

Craving

Recurring cravings

Eliminated with adequate dose

Craving may not be totally eliminated due to ceiling effect

Pregnancy and nursing

Heroin dependence poses grave risks for mother and fetus

Safe during pregnancy

Not indicated, however study underway

Experience of pain and emotions

Blunted

Normal pain and full range of emotions

Normal pain, but opioid analgesics may not be effective
May need to switch to methadone – Full range of emotions

Mood

 

Constant mood swings

Normal

Normal

Physical reaction time and intellectual functioning

Impaired

Reaction time normal Intellectual functioning unimpaired on stable dose

Reaction time presumed to be normal like methadone. FDA cautions driving and operating heavy machinery in the beginning of treatment

HIV & hepatitis C transmission

 

High rate with needle use and unprotected sex

Reduced/eliminated

Reduced/eliminated

Immune system for HIV positive persons

 

Rapid Progression to AIDS

Progression slowed with methadone

Progression presumed same as methadone – Data not available for buprenorphine

Immune/endocrine system functioning

 

Impaired

Normalized during treatment

Presumed normal during treatment – Data not available

Stress response

Suppressed

Normalized during treatment

Normalized during treatment

Criminal activity

 

High level

Reduced/eliminated

Reduced/eliminated

Personal relationships

Distributed

Potential for restoration, Improvement with counseling

Potential for restoration, Improvement with counseling

Employment

Deteriorating performance, loss of employment

Full functioning

Full functioning

Community impact

Destructive impact; high crime, high death rate, transmission of disease

Contributes to public health safety, low mortality, increased health

Contributes to public health safety, low mortality, increased health


Data: Substance Abuse & Mental Health Services Administration

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  • WELCOME
  • Southern California
    • Azusa, California
    • Bakersfield, California
    • Hawaiian Gardens, CA
    • Hawaiian Gardens, CA (Medical)
    • Hollywood, California
    • Inglewood, California
    • Inglewood, CA (Medical)
    • Lawndale, California
    • Lawndale, CA (Medical)
    • Long Beach, CA 90805 (Medical + NTP)
    • Long Beach, CA 90806
    • Los Angeles, California
    • Palmdale, California
    • Pico Rivera, California
    • Pico Rivera, CA (Eastside)
    • Pico Rivera, CA (Medical)
    • Santa Clarita, California
    • San Diego, California
    • Van Nuys, California
    • Van Nuys, CA (Medical)
    • Venice, California
  • Northern California
    • Marysville, California
    • Oakland, California
    • San Francisco, CA 94110
    • San Francisco, CA 94103
  • Texas Locations
    • Brownsville, Texas
    • Dallas, Texas
    • Houston, TX 77007
    • Houston, TX 77087
    • Pharr, Texas
  • Patient Resources
    • Entities >
      • American Health Services LLC
      • American Addiction Treatment Services, Inc.
      • El Dorado Community Service Center
      • El Dorado Texas Community Service Center
      • Fort Help LLC
      • Lifeline Treatment Services, Inc.
      • S.T.E.P. Med, Inc.
      • Texas American Medical Consultants, Inc.
      • Tavarua Health Services
      • Tavarua Medical Rehabilitation Services
      • West County Medical Clinic
      • West County Medical Corporation
    • Integrated Treatment
    • Patient Rights
    • Privacy Policy
    • HIPAA
    • About Us
    • Contact