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There are plenty of undesirable side-effects: can induce mild withdrawal symptoms in patients dependent on opioids; also diarrhoea, abdominal pain, anorexia, dyspepsia; vasodilatation; dyspnoea; paraesthesia, asthenia, fati- gue, agitation, anxiety; less commonly flatulence, taste disturbance, angina, hypertension, syncope, hypoxia, wheezing, cough, restlessness, depersonali- sation, dysarthria, impaired memory, hypoaesthesia, tremor, influenza-like symptoms, pyrexia, rhinitis, rigors, muscle cramp, myalgia, tinnitus, dry eye, and dry skin; rarely paralytic ileus, dysphagia, impaired concentration, and psychosis; very rarely retching, hyperventilation, hiccups, and muscle fasciculation --British National Formulary 59
As well as all the complications that come from self-injecting with potentially non-sterile equipment, and of things not intended for IV use (crushed pills have a number of inactive different binders and fillers that don't dissolve and get lodged somewhere in the body, typically the lungs[2]) It's metabolism can be pretty hard on the liver as well, which is a major concern if users have hepatitis from needle sharing/reuse.Another big problem is that since it operates as an opioid receptor anagonist (rather than an agonist, as practically all other opioids), the usual treatment for overdose -- Naloxone -- won't work very well. Buprenorphine also has a fairly hard effectiveness ceiling at ~32mg/day (although it would be a lucky/rich addict indeed who could afford that at €300/8mg quoted in the article) Finally, if an addict ends up in hospital or requires strong pain-relief, there's not a lot of options because the blockade effect will prevent (afaik) virtually all other opioids from working. [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1276621/ |