Buprenorphine (pronounced byoo-pre-nor-feen) is a medication used to treat opiate addiction. At low doses, buprenorphine helps those suffering from heroin addiction or prescription opiate addiction stop using the substance they've been abusing, without experiencing severe withdrawal symptoms. Buprenorphine is prescribed by a physician, and can be taken at home.
How does buprenorphine work?
Buprenorphine is what's called a partial opioid agonist, meaning it allows for less physical dependence than full opioid agonists like heroin or oxycodone. This makes buprenorphine it less likely to be misused or abused. It also means it only results relatively mild withdrawal symptoms when someone stops taking it, as opposed to extreme withdrawal symptoms that can result with sudden cessation of opioids like heroin or oxycodone.
Buprenorphine detox and treatment is often compared to methadone treatment, which is also used to treat opioid addiction, but is a full opioid agonist. Buprenorphine is frequently used to treat those struggling with prescription opioid addiction, while methadone is more commonly prescribed for those recovering from heroin addiction.
What does buprenorphine treat?
Buprenorphine is usually used to help treat those struggling with:
- Oxycodone addiction (addiction to OxyContin, Percocet, Percodan, Vicodin, etc.)
- Heroin addiction
With the correct dose, buprenorphine treatment can help to:
- Reduce cravings for opioids, thereby reducing illicit opioid use
- Suppress symptoms of opioid withdrawal
- Help patients stay in treatment
- Limit the effect of other opioids
- Increase safety in the event of overdose
What are the advantages of buprenorphine?
Buprenorphine is the first medication to treat opioid and opiate addiction that is approved to be prescribed and distributed by physicians. This gives it the significant advantage of being more accessible than other options, since patients can take it at home. Methadone, for example, is often only distributed out of methadone clinics, where patients are much more closely monitored.
Buprenorphine is also considered quite safe, due to its "ceiling effect". This means that at a certain point its effects don't increase even with increases in dosage, such that it's difficult to abuse. In addition to this lowered risk of addiction, buprenorphine treatment is generally regarded to have fewer side effects.
Finally, buprenorphine treatment it is beginning to be seen as a more long-term assistant in the journey towards sobriety. One common question explored in opioid addiction treatment is whether to wean a patient completely off the drug or to engage in maintenance therapy. Maintenance therapy is a process by which a former addict keeps taking low doses of an opioid like buprenorphine, to maintain their treatment and recovery.
Maintenance therapy is often recommended for those who've suffered from extreme drug addiction or who struggle with repeated relapse. Research out of Yale University also suggests that, in fact, for patients in treatment for prescription opioid dependence, buprenorphine maintenance therapy is actually superior to full detoxification (getting off all drugs completely).
About the study, researcher Dr. David Fiellin said, "It is very common for patients seeking treatment to request detoxification. They want to be off of everything as soon as possible as opposed to considering long-term treatment, but unfortunately there's no quick fix for the disease. The majority of patients will do better if they receive ongoing maintenance treatment".
What are the risks of buprenorphine?
There is some risk of a person becoming addicted to buprenorphine, but this is a limited risk due to the drug's ceiling effect.
Buprenorphine also has similar side effects to those of other opioids. These may include nausea, vomiting, constipation, muscle cramps, insomnia, irritability and fever. Patients should work in tandem with addiction specialists to find the correct dosage that limits side effects and maximizes positive impact.
Buprenorphine can also interact with other drugs in dangerous ways. It should be used with extreme caution when combined with other medications, especially other opioid agonists, other sedatives, and benzodiazepines (like Valium, Xanax, or Ativan). This is particularly important to understand should a patient taking buprenorphine need to have surgery at any point. Because buprenorphine can interact with anesthesia, always tell medical professionals you are taking buprenorphine as soon as possible.
Medications like buprenorphine are most effective when combined with counseling and other support (like therapy and 12-step groups). Addiction recovery is an ongoing process, and a very personal one. The path to sobriety and recovery will be different for each person, and a holistic approach – one that takes advantage of both medical assistance from drugs like buprenorphine as well as therapy – is almost always the most successful.