[stochastic_monk]

Exactly. Additionally, methadone increases cardiac mortality by increasing the QT interval, so the drug with better efficacy and safety profile should fully replace it.

Buprenorphine is good. And someone can’t get on it if they’re too addicted to opiates because as a partial agonist it can precipitate accelerated withdrawal, which acts as a protective mechanism, I imagine.

[mveety]

Buprenorphine also increases cardiac mortality by increasing the QT interval. Buprenorphine is used over methadone mostly because its a partial agonist of the mu-opioid receptor which basically limits how high you can get.

[stochastic_monk]

You’re right! I hadn’t known that buprenorphine also caused it, but it seems all of the drugs used for that purpose. I did find a 2013 study stating that the effect was significantly less than that from methadone, but it’s good to know that both come with cardiac risks.