Buprenorphine was approved by the FDA in 2002 as possible treatment for opiate addiction. Since its approval, several other variaions of this medication have been approved. Buprenorphine is used most commonly as an alternative to methodone, and is actually the first drug that is available to treat opioid dependency outside of a clinic. According to documents from the former agency. the National Drug Intelligence Center (NDIC), buprenorphine is “used to treat addiction to any type of opiate, including oxycodones such as OxyContin and Percocet.”
The NDIC goes on to explain, “Buprenorphine is a derivative of thebaine, an extract of opium. The drug is an opioid.” This means that even though buprenorphine is an opioid (produces opiate effects such as euphoria and respiratory depression) these effects are present in a lesser capacity compared to drugs that are full antagonists, such as methadone or heroin.
How Does Buprenorphine Work?
Buprenorphine is known for its ability to give people relief from pain, but it has become more widely utilized to help with the opiate detoxification process. When it comes to treating pain, buprenorphine binds to the same receptors as other opiates (including prescription painkillers), so it also has the same pain-relieving effects. The preparations consist of: Buprenex, Butrans, and Belbuca. For treatment of opiate addiction, the drug is used in conjunction with medication-assisted treatment (MAT), which is therapy to help people taper off opiates. Buprenorphine attaches to and engages the same opioid receptors as the abused drug, creating the same effects, and because of this reason, withdrawal effects are reduced. Just as other opiates, buprenorphine occupies the Central Nervous System, but in this case it causes decreased withdrawal symptoms.
What are the Side Effects of Buprenorphine
The liver is greatly affected by buprenorphine. Because of this a doctor may suggest routine blood work to monitor the liver functions of a person using buprenorphine. If pain medications such as morphine or codeine are taking alongside buprenorphine, the buprenorphine will block their effects. Although the risk of overdose is fairly low, a risk still does exist, especially if more is taken than necessary. Buprenorphine has been known to cause respiratory depression if not used correctly. This risk increases if ingested in conjunction with alcohol, antidepressants, benzodiazepines, sedatives, or tranquilizers. It can cause nausea, dizziness or lightheadedness, and may even cause a person to faint. However, many of these side effects may take place if buprenorphine is misused in high doses. For those people that take the recommended amount, the side-effects are relatively decreased.
Is Buprenorphine Addictive?
Buprenorphine can be addictive, although, it is not known to be as addictive as methodone or other opiates. Buprenorphine is similar to morphine, and has the potential for being abused. It is an opioid induces feelings of euphoria, therefore some people may use this drug in a manner other than prescribed by a doctor and in return develop a dependency.
Treating Opioid Addiction with Buprenorphine
According to the Substance Abuse and Mental Health Services Administration, the ideal candidates for treatment of opioid dependency using buprenorphine:
- Have been objectively diagnosed with a dependency of opioids
- Are willing to follow safety precautions for the treatment
- Have been cleared of any health conflicts with using buprenorphine
- Have reviewed other treatment options before agreeing to buprenorphine treatment
The Substance Abuse and Mental Health Services Administration Buprenorphine treatment happens in three phases:
- The Induction Phase is the medically monitored start of buprenorphine treatment performed in a certified physician’s office. The medication is administered when a person with an opioid dependency has abstained from using opioids for 12 to 24 hours and is in the early stages of opioid withdrawal. It is critical to note that buprenorphine can bring on acute withdrawal for patents who are not in the early stages of withdrawal and who have other opioids in their bloodstream.
- The Stabilization Phase will begin after a patient has discontinued or greatly reduced the misuse of the problem drug, no longer has cravings, and experiences few, if any, side effects. The dose of buprenorphine may need to be adjusted during this phase. Because of the long-acting agent of buprenorphine, once patients have been stabilized, they can sometimes switch to taking the medication alternating days instead of dosing every day.
- The Maintenance Phase will occur when a patient is doing well on a steady dose of buprenorphine. The length of time of the maintenance phase is tailored to each patient and could be indefinite. Once an individual is stabilized, an alternative approach would be to go into a medically supervised withdrawal, which makes the transition from a physically dependent state smoother. People then can engage in further rehabilitation—with or without MAT—to prevent a possible relapse.
Treatment of opioid dependency with buprenorphine is most effective in combination with counseling services, which can include different forms of behavioral therapy and self-help programs.