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Buprenorphine for Opioid Addiction Treatment

Opioid use disorder is considered a serious public health issue in the US, as it can lead to overdose, disability, and even death.

Navigation: What is Buprenorphine and What Does it Do?, What Are the Side Effects of Buprenorphine?, What Are the Types of Buprenorphine?, Can Buprenorphine Interact with Other Drugs?, Can You Overdose on Buprenorphine?, Buprenorphine Considered Safe for Use in the Emergency Department for People Who Take Fentanyl, Is Buprenorphine Addictive?, Rehab Is Your Best Chance

 

Opioids are primarily used as painkillers, but these substances can also produce feelings of euphoria and relaxation, which sometimes leads to substance abuse. In some cases, the result of taking opioids is opioid use disorder.

Opioid use disorder (OUD) is a chronic medical condition that results from the repeated use of opioids, including prescription pain medications, such as oxycodone and hydrocodone, as well as illegal drugs like heroin.

This condition is characterized by a strong compulsion to use opioids despite the negative consequences of continued use. It is also known as opioid addiction. Addicted individuals experience negative effects on their physical and mental health, as well as their relationships and finances.

OUD can lead to tolerance, meaning that higher doses of opioids are needed to achieve the same effect.

Opioid use disorder is considered a serious public health issue in the US, as it can lead to overdose, disability, and even death.

According to the National Institute on Drug Abuse (NIDA), in 2020, an estimated 1.5 million people in the United States had an opioid use disorder, and there were more than 69,000 overdose deaths involving opioids. The opioid epidemic has been a growing problem in the US for several decades, and it has had a significant impact on public health, social welfare, and the economy.

Many factors have contributed to the opioid epidemic, including over-prescription of opioid painkillers, illicit manufacturing and distribution of fentanyl, and lack of access to effective treatment for addiction.

Efforts are being made at the federal, state, and local levels to address the opioid epidemic, including increasing access to addiction treatment, improving prescribing practices, and cracking down on illegal drug trafficking.

Part of this effort is finding the best treatments for those who are struggling with substance abuse. Opioid treatment programs can involve the use of full opioid agonists to prevent the effects of these substances.

Buprenorphine drug maintenance treatment is a form of substance abuse treatment which we will talk about today. Here we will talk about buprenorphine and how it helps people with opioid dependence and opiate addiction. Let’s take a closer look.

 

What is Buprenorphine and What Does it Do?

Buprenorphine is a medication used to treat opioid addiction by reducing withdrawal symptoms and cravings for opioids. It is a partial opioid agonist, which means it activates the same receptors in the brain as other opioids, but to a lesser degree, and therefore produces less of a “high” and lower risk of overdose.

Similar to methadone treatment, buprenorphine is often used as part of medication-assisted treatment (MAT), which combines medication with counseling and behavioral therapies to help individuals recover from opioid addiction.

Studies involving buprenorphine maintenance versus placebo shows that this is effective when it comes to reducing opioid use and therefore preventing overdose deaths. With MAT, it is also possible to avoid many other negative outcomes associated with opioid addiction.

One of the advantages of buprenorphine is that it can be prescribed by qualified healthcare providers in an office-based setting, which makes it more accessible to individuals seeking treatment for opioid addiction.

However, it is important to note that buprenorphine should only be used under the supervision of a healthcare professional and as part of a comprehensive treatment plan.

Sometimes it is given in the form of a patch that is applied to the skin when treating pain. When administered this way, it can provide pain relief for seven days. But for the treatment of opioid addiction, it is commonly combined with naloxone, usually as a pill that is taken sublingually. Buprenorphine plays an important role here because naloxone may cause withdrawal if injected, so the addition of buprenorphine actually prevents opioid dependent patients from misusing the drug.

Buprenorphine treatment is allowed because of The Drug Addiction Treatment Act (DATA), which is a United States federal law that was enacted in 2000. The law permits qualified physicians to prescribe certain medications, such as buprenorphine, for the treatment of opioid addiction outside of traditional opioid treatment programs (OTPs).

Prior to the enactment of the DATA, physicians were required to have a special waiver in order to prescribe buprenorphine for the treatment of opioid addiction. The DATA removed this requirement and allowed for qualified physicians to prescribe buprenorphine as part of an office-based treatment program.

Buprenorphine is a long-acting opioid that can be used to replace shorter-acting and addictive opioids like fentanyl, oxycodone, hydromorphone, and heroin. Because buprenorphine treatment is long-acting, the drug acts more slowly within the body and stays there for a longer period of time. Taken correctly, it can prevent withdrawal and reduce cravings. However, keep in mind that misusing buprenorphine has its own consequences.

Buprenorphine therapy for opioid addiction should be combined with proper medical and supportive care in order to produce the best results.

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What Are the Side Effects of Buprenorphine?

Like all medications, buprenorphine may cause side effects, some of which are mild and may go away on their own, while others are severe and may require medical attention.

Here are some common side effects of buprenorphine: nausea, vomiting, constipation, dry mouth, headache, dizziness, drowsiness, changes in sex drive, sweating, sleep problems, weight gain, stomach pain, and back pain. It may also cause withdrawal symptoms in some cases, especially if taken too soon after opioids.

More serious side effects of buprenorphine may include: breathing difficulties, severe dizziness, fainting, feeling lightheaded, seizures, confusion, blurred vision, allergic reactions, and hallucinations. If you experience any of these serious side effects, seek medical attention immediately.

It is important to note that this is not a complete list of all possible side effects. Be sure to talk to your doctor or healthcare provider about any concerns or questions you may have regarding buprenorphine.

What Are the Types of Buprenorphine?

There are several types of buprenorphine available on the market. Here are some of the common types:

Suboxone: This medication is a combination of buprenorphine and naloxone. It is used for opioid addiction treatment and helps reduce cravings and withdrawal symptoms.

Subutex: This medication contains only buprenorphine and is also used for opioid addiction treatment. It can be used during the early stages of treatment or for patients who cannot take naloxone.

Belbuca: This medication is a buccal film that is placed on the inside of the cheek. It is used for pain management in people who require continuous opioid treatment.

Butrans: This medication is a transdermal patch that is used for chronic pain management. It delivers a continuous dose of buprenorphine over a seven-day period.

Another type is buprenorphine/naloxone which is a pill that can be absorbed under the tongue.

Regardless of the type, buprenorphine should only be taken under the guidance of a healthcare professional, and the type of buprenorphine prescribed will depend on the patient’s specific needs and medical history.

Can Buprenorphine Interact with Other Drugs?

Because buprenorphine can interact with other drugs, it is important to tell your doctor or pharmacist about all the medications you are taking, including prescription, over-the-counter, and herbal products, to avoid dangerous drug interactions.

For example, buprenorphine may interact with benzodiazepines. Combining buprenorphine with benzodiazepines (such as alprazolam, diazepam, or lorazepam) is particularly dangerous because it can increase the risk of respiratory depression, coma, and death.

The same can be said when you combine buprenorphine with other opioids like oxycodone, morphine, and hydrocodone.

Other medications, such as antihistamines, sedatives, muscle relaxants, or anti-anxiety medications, can interact with buprenorphine and increase the risk of side effects.

Keep in mind that this list is not exhaustive, and other drugs may interact with buprenorphine. Always consult with your healthcare provider before starting or stopping any medication.

Can You Overdose on Buprenorphine?

Unfortunately, it is possible to overdose on buprenorphine, particularly when it is taken in higher doses than prescribed or when it is used in combination with other substances such as alcohol or benzodiazepines. The risk of a buprenorphine overdose is also increased when the medication is taken too frequently.

Buprenorphine is a potent opioid medication used to treat opioid addiction and chronic pain, and it can cause respiratory depression, which can lead to coma or death if not treated promptly.

The symptoms of a buprenorphine overdose can include slowed or shallow breathing, pinpoint pupils, cold and clammy skin, blue lips and nails, extreme fatigue, confusion, dizziness, severe drowsiness, loss of consciousness, and even coma. In severe cases, an overdose can lead to respiratory failure and death.

If you or someone you know is experiencing symptoms of a buprenorphine overdose, seek immediate medical attention by calling emergency services or going to the nearest emergency room. A buprenorphine overdose can be treated with medication to reverse the effects of the drug and support vital functions such as breathing and heart rate.

Buprenorphine should only be taken as prescribed by a healthcare professional, and any concerns about its use should be discussed with a doctor. It’s worth noting that although all opioids have a risk of overdose, the risk is higher with methadone than with buprenorphine.

Buprenorphine Considered Safe for Use in the Emergency Department for People Who Take Fentanyl

In recent years, there has been an increasing interest in using buprenorphine in the emergency department (ED) setting to treat patients with opioid use disorder (OUD) who are in acute withdrawal.

Several studies have shown that the use of buprenorphine in the ED is both safe and effective. Buprenorphine has been shown to reduce the severity of withdrawal symptoms, shorten the length of stay in the ED, and increase the likelihood of patients seeking follow-up treatment for OUD.

One particular study found that the medication can be safely started in the ED by people who use fentanyl either alone or with other drugs.

Previous studies have established that high doses of buprenorphine can be safely used to treat opioid withdrawal in the emergency department. Buprenorphine treatment can even provide relief within a few hours, reducing cravings and allowing people to transition to outpatient drug treatment sooner.

However, other studies raised concerns that buprenorphine may not be safe for people who take fentanyl. Doctors expressed concern about triggering a ‘precipitated withdrawal’ which is a reaction that involves symptoms like nausea, vomiting, abdominal cramps, and diarrhea. This can occur within two hours after taking buprenorphine.

This new NIH-funded study led by Dr. Gail D’Onofrio from Yale University has set out to determine if the drug is safe for patients treated with fentanyl. They found that that is the case. The researchers have conducted a large clinical trial involving 1,200 people with moderate to severe OUD who visited emergency departments in the US between 2020 and 2022. Half of them were injected with  the extended-release version of buprenorphine. The rest of them received it in the form of a tablet or film that dissolves under the tongue.

The researchers then observed if there were incidences of precipitated withdrawal. Out of 1,200 people, only 9 of them experienced precipitated withdrawal after taking buprenorphine. This represents less than 1% of the participants.

Accounting only for those who took fentanyl, the rate of precipitated withdrawal remained at around 1%. Over 85% of participants who started buprenorphine treatment in the ED continued with follow-up care.

Researchers agree that wider use of buprenorphine may be able to reduce the growing number of overdose deaths linked to fentanyl. Drug overdose deaths continue to climb in the US. In fact, it is now reaching over 100,000 a year. Fentanyl and other powerful synthetic opioids have driven this dramatic increase.

Considering the US is in an overdose crisis, it is good that there are treatments available that are safe to use.

That said, there are some challenges to implementing buprenorphine treatment in the ED. One challenge is that ED physicians may not have the necessary training or expertise to initiate buprenorphine treatment. Additionally, there are regulations and legal requirements that must be followed when prescribing buprenorphine for OUD treatment.

Despite these challenges, the use of buprenorphine in the ED has the potential to improve outcomes for patients with OUD and reduce the burden on the healthcare system. Healthcare providers and policymakers are working to overcome these challenges and expand access to buprenorphine treatment in the ED.

Is Buprenorphine Addictive?

Despite its benefits, buprenorphine can be addictive. In fact, buprenorphine is classified as a Schedule III controlled substance due to its potential for abuse and addiction.

While buprenorphine is less addictive than other opioids, it still carries a risk of dependence and addiction.

Patients who are receiving buprenorphine should take it exactly as prescribed by their healthcare provider. Do not take more than the recommended dose or use it more frequently than prescribed.

Just like any other drug, it can be abused. This may lead to various negative effects on the body and mind. Some of the effects of buprenorphine abuse include:

Physical dependence: Buprenorphine is an opioid, and like other opioids, it can cause physical dependence. People who abuse buprenorphine may experience withdrawal symptoms if they try to stop using the drug.

Respiratory depression: Buprenorphine can slow down breathing, which can be dangerous, especially if taken in large doses or combined with other drugs that depress breathing.

Liver damage: Buprenorphine can cause liver damage, particularly when taken in high doses or over a prolonged period.

Mood changes: Buprenorphine abuse can cause mood changes, including depression, anxiety, and irritability.

Cognitive impairment: Buprenorphine abuse can impair cognitive function, including memory, attention, and decision-making abilities.

Increased risk of infectious diseases: Injecting buprenorphine or sharing needles with others can increase the risk of contracting infectious diseases, such as HIV or hepatitis.

Abruptly stopping buprenorphine use can also cause withdrawal symptoms, which can be uncomfortable or even dangerous.

If you have concerns about the potential for addiction with buprenorphine or any other medication, it’s important to talk to your healthcare provider. They can help you understand the risks and benefits of treatment and develop a plan that’s tailored to your needs.

It is essential to seek medical help if you or someone you know is struggling with buprenorphine abuse. Treatment for buprenorphine addiction may include detoxification, therapy, and medication-assisted treatment.

With this in mind, the benefits of buprenorphine are undeniable. It is a partial opioid agonist, meaning it activates the same receptors in the brain as opioids, but to a lesser extent. This helps to reduce cravings and withdrawal symptoms, making it easier for people to stop using opioids.

Compared to other opioids buprenorphine also has a lower risk of overdose thanks to its ceiling effect. Buprenorphine has a maximum effect on the opioid receptors in the brain. This makes it less likely for someone to overdose on buprenorphine compared to other opioids, but the possibility is still there.

Buprenorphine has been shown to be safe and effective in treating opioid addiction, and it is approved by the FDA for this use. It can be used as part of a comprehensive treatment plan that includes counseling and behavioral therapy.

Unlike methadone, which can only be dispensed at licensed clinics, buprenorphine can be prescribed by qualified primary care providers. This makes it more accessible to people who live in rural areas or who have difficulty accessing specialized treatment.

This drug can help people with opioid addiction to regain control of their lives, improve their relationships, and reduce the risk of legal and financial problems associated with drug use.

The best treatment option for you will depend on your specific condition. If you or your loved one is struggling with an opioid use disorder, look for a rehab near you today and find out more about your various treatment options. Addiction treatment should be personalized depending on the patient’s specific needs. Get started on the road to recovery today.

Rehab is Your Best Chance

Treatment is an addicted individualʼs best option if they want to recover. Beating an addiction not only requires eliminating the physical dependence, but also addressing the behavioral factors that prevent them from wanting to get better. Simply quitting may not change the psychological aspect of addiction. Some people quit for a while, and then take drugs or alcohol again, only to overdose because they did not detox properly. Recovery involves changing the way the patient feels, thinks, and behaves.

 

author avatar
Fel Clinical Director of Content
Felisa Laboro has been working with addiction and substance abuse businesses since early 2014. She has authored and published over 1,000 articles in the space. As a result of her work, over 1,500 people have been able to find treatment. She is passionate about helping people break free from alcohol or drug addiction and living a healthy life.

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