By Rick Collins, J.D.

Q: I saw a recent HBO documentary about an extreme fighter hooked on Nubain. Is Nubain a controlled substance?

A: Nalbuphine (pronounced "NAL-byou-feen") hydrochloride, commonly called by the brand name Nubain® or simply "Bain," is an injectable synthetic prescription drug common among some bodybuilders who use it for its reported ability to take the edge off dieting, to improve fat burning by increasing T-3 uptake, and mostly as a mild analgesic to alleviate the various pains associated with heavy training. It provides a "functional high" and a slight numbing effect that doesn't interfere with ordinary activities, including lifting. Doesn't sound too shabby, huh? Well, read on before drawing any conclusions.

Once upon a time, nalbuphine was a controlled substance. Like most other opiates, it fell within Schedule II of the Controlled Substances Act (21 U.S.C. § 812) as a drug deemed to have a high potential for abuse that may lead to severe psychological or physical dependence. But in 1973, a pharmaceutical company looking to make money marketing the drug made a pitch claiming that nalbuphine did not have sufficient potential for abuse to justify its continued control. They made an appealing case. Like morphine, nalbuphine is a painkiller that exerts agonistic or stimulating effects on the body's opiate receptors. But unlike morphine, nalbuphine is also an antagonist or blocker to certain opiate receptors. The result of this mixed agonist/antagonist character is a built-in "ceiling" or safety net that provides a mild analgesic effect without the euphoria or potential for deadly overdose associated with morphine and other opiates. This self-inhibiting and non-toxic character makes nalbuphine significantly less attractive to typical drug addicts. Accordingly, nalbuphine can be argued to be much less addictive than other opiates. Well, the FDA bought the argument. They recommended to the DEA that nalbuphine be removed entirely from the schedules of controlled substances, conveniently paving the way for the drug company's profits. The DEA obliged, and to this day nalbuphine remains specifically excluded from the list (see 21 C.F.R. § 1308.12). The DEA just doesn't view it as a drug of abuse.

But anecdotal accounts say otherwise. While extreme fighter Mark Kerr in the HBO report appeared to be additionally using various other opiates, reports of psychological addiction to nalbuphine abound. A few elite level bodybuilders have publicly described their experiences with nalbuphine dependency. Online bodybuilding forums regularly detail various nalbuphine abuse stories. State law enforcement authorities have begun to take interest in physicians who facilitate non-medical nalbuphine users, and one physician was recently convicted for prescribing nalbuphine for other than legitimate and therapeutic purposes (see, State v. Clausing, 15 P.3d 203 (2001).) While controversy continues over the nature and intensity of nalbuphine addiction, there's no doubt that a certain percentage of users get a little too used to the pain relief and mellowing that nalbuphine provides. As a user's tolerance increases, dosages can edge up, intravenous injections can become preferable to intramuscular ones, and shooting up throughout the day can become a routine and vital part of life.

However you might feel about the ethics of administering steroids as a tool for muscle building, nalbuphine use may be quite different. Some bodybuilders are going beyond treating pain and may be simply using nalbuphine as a recreational drug. Still, the DEA seems happy to look the other way. Instead, they're busy helping anti-doping special interest groups to goad Congress into viewing over-the-counter sports supplements like androstenedione as drugs of abuse. Legislation to criminalize prohormones is already pending in Washington, and if it passes, mature health-conscious adults will be prosecuted as federal drug criminals for having these products for personal use USFA.biz for further information). Interesting governmental priorities, indeed.

Anyway, regardless of the legalities, if you're a healthy bodybuilder, the safest choice is to let the Bain Train pass you by.

Rick Collins, J.D., a veteran lawyer and former competitive bodybuilder, is the author of the controversial new book LEGAL MUSCLE: Anabolics in America, available through this site. [© Rick Collins, 2003. All rights reserved. For informational purposes only, not to be construed as legal advice.]