ReviewPharmaceuticals (Basel, Switzerland)2026
Can Buprenorphine Be Overdosed? The Ceiling Effect and Its Clinical Implications.
Review in Pharmaceuticals (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Opioids comprise a class of substances characterized by a narrow therapeutic window and significant euphoric effects. Opioid-related mortality remains a critical global health issue, primarily resulting from respiratory depression associated with full μ-opioid receptor agonists. Buprenorphine is distinguished by its pharmacological profile as a partial μ-opioid receptor agonist, exhibiting a ceiling effect on both respiratory depression and euphoria. These characteristics render buprenorphine particularly valuable in opioid replacement therapy for opioid use disorder and in the management of both chronic and acute pain. Current literature indicates that, due to these properties, buprenorphine possesses a superior safety profile compared to other opioids. This narrative review evaluates whether buprenorphine can cause fatal overdose despite its protective ceiling effect and examines cases of buprenorphine-related fatalities. The review synthesizes data from pre-clinical, clinical, pharmacological, and toxicological studies. Current literature supports the consensus that the established ceiling effect on respiratory depression does not fully eliminate the risk of fatal overdose. Polysubstance use, particularly co-ingestion of other central nervous system depressants, significantly increases this risk, and most buprenorphine-related deaths involve such combinations. Additionally, buprenorphine's safety is reduced in vulnerable populations, including opioid-naive individuals, children, and patients with pre-existing respiratory compromise. While buprenorphine alone presents a substantially lower fatality risk compared to other opioids, the ceiling effect is pharmacodynamic rather than absolute, and toxicity or fatal overdose may still occur. Current data gathered from clinical and pre-clinical studies suggest that buprenorphine is safer than full μ-opioid receptor agonists, but it is not without risk. The ceiling effect's protective benefits depend on context. Therefore, despite its improved safety profile, buprenorphine should not be regarded as risk-free.
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Registered trials
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 OpenQuestion graph.