Yes, buprenorphine is an opioid used in drug addiction treatment. However, there are several reasons that qualified prescribers use one opioid drug to defeat physical dependency on another opioid. Research shows that people with opioid use disorder (OUD) following detoxification with an abstinence program are likely to return to using opioid drugs. Relapse is considered a normal event on the user’s road to recovery, but it may put the individual at risk for a drug overdose. Medicine-assisted therapy (MAT) helps the patient by introducing other medications that lessen cravings and withdrawal symptoms without producing the euphoric effects of the original opioid drug. Buprenorphine, a partial opioid agonist, is a frequently used drug used in addiction treatment:
- The drug binds to the patient’s opioid receptors in the same way as the addictive drug but activates these receptors less well than the “full agonist” drug does.
- Patients generally tolerate buprenorphine well.
- It’s similarly considered as effective as methadone in the treatment of OUD.
Buprenorphine, approved by the FDA in 2002, was the first medicine deemed eligible for use in MAT by certified doctors under the Drug Addiction Treatment Act. It has been prescribed for the treatment of OUDs since 2002 in tablet form and since 2010 in sublingual form. Poor adherence to taking buprenorphine was a hurdle for many patients in recovery for OUDs. For that reason, the FDA approved a six-month subdermal implant (2016) and a once-a-month buprenorphine injection (2017). These formulas help stabilize patients using buprenorphine to stay on track on a maintenance treatment program. Because the effects are long-lasting, the subdermal implant and monthly injections are good options for those who struggle to take the medication as prescribed.
Buprenorphine helps people to reduce or completely cease their use of opiates, e.g. morphine, or heroin. When used in concert with behavioral therapies and counseling, buprenorphine is considered safe and effective. The active ingredient in buprenorphine is suboxone:
- The drug’s high affinity for the brain’s mu receptor helps to displace the patient’s use of opoid full agonist drugs.
- For this reason, buprenorphine has relatively low abuse potential.
- Its lower level of potential physical dependence lessens the discomfort associated with opioid withdrawal symptoms.
- Buprenorphine’s ceiling effect inhibits the likelihood of overdose. However, it is considered a safer drug in overdose (less likely to result in a fatal respiratory depression than full agonist opioid drugs).
Buprenorphine is midpoint between full agonists, e.g. LAAM or methadone) and opioid antagonist drugs, e.g. nalmefene or naltrexone. OUD patients often say that taking buprenorphine as directed by their physician makes them “feel normal.” When consumed in higher dosages or under specific circumstances, buprenorphine’s antagonist properties may precipitate acute withdrawal in OUD patients who are dependent on full agonist opioid drugs. Although buprenorphine displaces the full agonist drug from the brain’s mu receptors, it doesn’t equally activate the receptors. This results in a rapid onset of withdrawal. If injected into the bloodstream, buprenorphine can create euphoric symptoms. It can also create physical dependency, but appears to do so less well than full agonists.
Unlike methadone, which is used in a clinical setting only, buprenorphine may be dispensed or prescribed in physician’s offices. The Drug Addiction Treatment Act (DATA 2000) allows qualified physicians in a correctional facility, office, health department, or community hospital, to prescribe buprenorphine for OUDs. Opioid treatment programs (OTPs) may also dispense buprenorphine in treatment.
Buprenorphine, like all medicines used in MAT, is part of a complete treatment program that includes social support and counseling programs. FDA-approved buprenorphine formulas includes Suboxone (naloxone and buprenorphine) film, Zubsolv (naloxone and buprenorphine) sublingual, Bunavail (naloxone and buprenorphine) buccal film, and other transmucosal delivery products for OUD treatment that contain buprenorphine.
Buprenorphine’s unique properties help increase safety in the event of an overdose, lower the potential for misuse, and lessen the effect of opioid dependency in the detoxification process.
If you or someone you love is struggling with drug addiction, call us today at 833-680-0165.