Are you looking to learn more about buprenorphine? Perhaps you’ve heard about the drug and are wondering if it’s right for you.
In this article, we’ll delve into what buprenorphine is, how it works, and what it is commonly used for. We’ll also cover the effects of buprenorphine, and who buprenorphine is best suited for to help you understand whether it’s right for you.
Understanding Buprenorphine
Before we get into the specifics, let’s take a look at the basic background of what buprenorphine is.
Buprenorphine is a synthetic opioid, meaning that it produces all the effects of opioid drugs such as euphoria, relaxation, decreased breathing rate, loss of appetite, and pain relief.
Unlike other well known opioids such as methadone and heroin, buprenorphine is a partial opioid agonist.
This means that the drug only partially activates mu-opioid receptors. As a result, at a certain point, larger amounts of the drug do not produce larger effects.
This is referred to as a “ceiling effect”, where larger and larger doses of the drug will not create larger sensations of euphoria or sedation.
Buprenorphine is approved for use as a painkiller and as a therapeutic treatment option for opioid use disorder by the FDA. We’ll look into the specifics of each of these uses in more detail below.
Buprenorphine in Opioid Addiction Treatment
Buprenorphine was approved for use as a treatment of opioid use by the FDA in 2002.
Buprenorphine works for opioid addiction by acting as a substitution drug that prevents withdrawal effects from occuring when ceasing the drug of abuse.
As buprenorphine is also only a partial agonist, it is safer to consume without the risk of high dose causing respiratory depression.
Once the patient has ceased the drug of abuse, buprenorphine can be administered to avoid the acute withdrawal symptoms that will occur and prevent the risk of relapse.
This is because taking buprenorphine tricks the body into believing you are still taking the opioid of abuse, without experiencing the usual degree of euphoria and other effects.
Buprenorphine vs Methadone
Another drug commonly used in treating opioid disorder is methadone.
Unlike buprenorphine, methadone is a full opioid agonist and does not have the same ceiling effect that buprenorphine has.
As a result, methadone is a slightly less safe option that holds greater risk of overdose and of misuse, abuse or dependence.
However, more severe opioid addiction may require methadone as buprenorphine may not be strong enough to be effective.
Buprenorphine vs Naltrexone
Another medication-assisted treatment used in opioid addiction is naltrexone. Unlike buprenorphine, naltrexone is an opioid antagonist – meaning that it prevents opioids from producing their usual effects (such as euphoria) when taken.
Therefore, a once-a-month injection of naltrexone can help individuals with opioid use disorder by removing this addicting high.
Buprenorphine Treatment in Pain Management
Buprenorphine is also used for the management of chronic and severe pain.
This is due to the strong pain relief effects it possesses, with the associated euphoria and respiratory depression of opioids reaching a plateau at high doses.
This reduces the risk of dependence, overdose, and potential abuse of the drug by the individual.
In addition, buprenorphine is long-lasting and can provide approximately 8 hours of pain relief.
Buprenorphine is often administered in emergency room settings to patients where their history is unknown.
This is because buprenorphine holds a lower risk of triggering addiction in individuals with opioid use disorder. In addition, buprenorphine presents a lower risk of respiratory depression and physical dependence in the general population.
How Buprenorphine is Taken
Buprenorphine can be taken by three main methods: orally through buccal films, via injection, or by using skin patches. Let’s take a look at each of these forms of buprenorphine in more detail:
Buccal Films
Oral tablets or films are placed on the cheek to be more readily absorbed into the bloodstream.
In the case of treatment for opioid use disorder, a starting dose of 2 – 4 mg is typical. Dosage may then be increased by amounts of 2 – 4 mg to the lowest amount needed for stabilization.
These films may also be used in the case of severe chronic pain. The films are applied to the cheek inside the mouth and dissolve within 30 minutes.
After applying the buccal film, you should not eat or drink anything until the film is completely dissolved. These films are also long-lasting and may only need to be taken once or twice a day.
Skin Patches
Another method of administering buprenorphine is through skin patches.
These skin patches are used for patients with severe and ongoing pain. Through applying the skin patches, the patient then experiences extended pain relief.
These patches are not suitable for individuals with mild to moderate pain, or for pain that is not chronic.
Skin patches are applied to a clean, dry area of skin. To apply the skin patch, the protective layer is removed, and the patch is then pressed onto the skin with the adhesive side facing down.
Areas the patch can be applied include the back, upper arm, or upper chest.
Injections
Lastly, injections are the final method of administering buprenorphine. These extended-release injections are long-lasting and can be given once a week or once a month.
In the case of treating opioid dependence, buprenorphine will be injected by your medical professional.
A starting monthly dose is usually 300 mg. Once injected, the liquid turns into a solid gel – allowing the buprenorphine to be released over time.
The injection works in the same manner for treating severe pain, and again can only be given by a doctor or other health care professional.
As injections can only be administered by a medical professional, this may be the preferred option for individuals who are more at risk of abusing the drug or developing physical dependence.
Should You Take Buprenorphine?
So, how do you know if buprenorphine is right for you?
If you are currently struggling with opioid use disorder, talk to your doctor about the potential use of buprenorphine in your treatment plan.
If you have a more severe addiction, buprenorphine may not be the best medication for you. However, you should discuss your options with your regular doctor.
In terms of using buprenorphine for pain relief, you may be a good candidate if you struggle with chronic or severe pain that needs around-the-clock relief.
Examples of this may be in cancer patients or other medical situations where the pain is long-lasting. The drug is not suitable for individuals who experience more moderate or transient pain, or for acute pain management.
Due to the potential for buprenorphine to create adverse effects such as addiction and dependence, it’s important to consider your options carefully and to discuss these with your medical provider.
Final Thoughts
As we’ve seen, buprenorphine is a synthetic opioid that can be used both as a medication-assisted treatment of opioid use and as a painkiller for severe and chronic pain.
Buprenorphine differs from many other opioids due to being a partial opioid agonist.
This means that there is a limit to the effects an individual can experience from the drug even at high doses, making it a safer option than many other opioids and decreasing your chance of overdose.
Buprenorphine has helped many people in their journey to recovery. If you think treatment with buprenorphine cuold potentially help you, talk to your medical professional today to discuss your options.
Sources
- https://www.ncbi.nlm.nih.gov/books/NBK459126/
- https://psychopharmacologyinstitute.com/section/buprenorphine-for-opioid-use-disorder-mechanism-of-action-2037-4002
- https://www.samhsa.gov/medications-substance-use-disorders/medications-counseling-related-conditions/buprenorphine
- https://store.samhsa.gov/sites/default/files/sma14-4442.pdf
- https://www.hazeldenbettyford.org/articles/methadone-vs-suboxone-opioid-treatment
- https://www.jpsmjournal.com/article/s0885-3924(04)00566-4/fulltext
- https://www.chcf.org/wp-content/uploads/2019/08/BuprenorphineOverviewClinicians.pdf
- https://medlineplus.gov/druginfo/meds/a616019.html#how
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