SAMCRO
Bluelighter
Buprenorphine, a partial antagonist, has a stronger affinity for the Mu opioid receptor (the receptor responsible for feelings of euphoria and well being) than full agonist opiates. At the same time, it has a lower intrinsic effect, so while it occupies the same space in the receptor and trumps the other opioids, it activates them to a much lesser degree.
When we directly replace full agonist opioids with buprenorphine, the result is an unpleasant shock as the entire receptor site is more or less spontaneously replaced by something with less 'net activation'. The user feels an immediate loss of comfort due to the entire receptor site being attenuated all at once.
Gradual Titration allows the buprenorphine to slowly trade places with the full agonist opioids without the user knowing because there is no average "net loss" of receptor activation which is the feeling of being high.
Eventually at the end of the titration, the buphrenorphine now covers the entire receptor area, but the user never became physically aware of this transformation in any sort of unpleasant way, because it took place in a gradual fashion.
Sorry about the bad metaphors in the previous post.
You are definitely wrong about gradual titration of bupe ending the possibility of Precip. W/D. It may play a tiny role in lessening the severity but there have been many reports of heroin overdoses that are reversed by placing a small amount of bupe under the persons tongue which kicks off the full agonist Heroin and this in turn awakens their CNS so that they can breath on their own. This is basically the same as putting the OD victim into precip. W/D.