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Fasano, a world-renowned gastroenterologist, in order for autoimmunity to be triggered, three factors must be present (this is referred to as the three-legged stool of autoimmunity): [1] A genetic predisposition Intestinal permeability/leaky gut A triggering event or root cause factor Each of these three legs or factors plays its own role in triggering autoimmunity (explained throughout this article)

Buprenorphine, also an opioid, also has a significant long-term side effect profile, including over 60% of patients reporting sleep disturbances that may interfere with treatment

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Evidence increasingly supports an elevated risk associated with persistent, intensive NSW, particularly when initiated early in life or combined with genetic susceptibility