Evidence map›Paper›PMID 41802339›Full record

ArticleAddiction biology2026

The Buprenorphine Paradox: How Buprenorphine Triggers and Resolves Opioid Withdrawal.

Mehdi Haghdoost, Jennifer LaBranche, Matthew Roberts, Victor W Li, Jane J Kim, James S H Wong, Pouya Azar

Abstract read
In one paragraph

Article in Addiction biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mehdi HaghdoostAidos Innovation, Sheridan, Wyoming, USA.
Jennifer LaBrancheComplex Pain and Addiction Service, Department of Psychiatry, Vancouver Coastal Health, Vancouver, Canada.
Matthew RobertsAidos Innovation, Sheridan, Wyoming, USA.
Victor W LiComplex Pain and Addiction Service, Department of Psychiatry, Vancouver Coastal Health, Vancouver, Canada.
Jane J KimComplex Pain and Addiction Service, Department of Psychiatry, Vancouver Coastal Health, Vancouver, Canada.
James S H WongComplex Pain and Addiction Service, Department of Psychiatry, Vancouver Coastal Health, Vancouver, Canada.
Pouya AzarAidos Innovation, Sheridan, Wyoming, USA.ORCID 0000-0003-3030-311X

Funding

VGH and UBC Hospital Foundation
6 · The paper itself

Abstract

Buprenorphine (BUP) offers a therapeutic approach for opioid use disorder (OUD) due to its unique pharmacodynamic properties, primarily as a partial agonist with high affinity for the mu-opioid receptor (MOR). BUP's partial agonism and ceiling effect on respiratory depression enhance its safety profile. However, BUP can induce precipitated withdrawal when administered after a full agonist, leading to severe withdrawal symptoms. This Perspective builds on prior work that has linked BUP's high-affinity partial agonism to precipitated withdrawal and low-dose induction strategies. We focus on how BUP's capacity to promote MOR externalization, together with its activity at the nociceptin opioid peptide (NOP) receptor, can help explain why it precipitates withdrawal when administered in the presence of full agonists yet relieves withdrawal once spontaneous withdrawal has begun. Understanding these mechanisms is critical for optimizing BUP protocols in OUD treatment and informs the potential development of new biased MOR agonists (i.e., ligands that preferentially activate specific signalling pathways) for addiction therapy.

Indexed as

Analgesics, OpioidBuprenorphineNarcotic AntagonistsOpioid-Related DisordersReceptors, Opioid, muSubstance Withdrawal SyndromeAnimalsDrug Partial AgonismHumansNociceptin ReceptorOpiate Substitution TreatmentReceptors, OpioidAnalgesics, OpioidBuprenorphineNarcotic AntagonistsNociceptin ReceptorReceptors, OpioidReceptors, Opioid, mubiased agonistsbuprenorphinemu‐opioid receptoropioid use disorderprecipitated withdrawal

Identifiers

PMID41802339
PMCPMC12971109

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.