Buprenorphine Treatment

Published on 1/31/11
Categorized in Heroin Addiction
Buprenorphine Treatment

Buprenorphine, or "Bupe" for short, is an opioid drug that can be used to treat pain, just like morphine, oxycodone or codeine. It can also be used to treat addiction to these painkillers or to illicit opioids like heroin. It does not treat addiction to non-opioid drugs like cocaine.

Treating Addiction with Buprenorphine

There are two formulations of buprenorphine approved specifically to treat opioid addiction: Subutex (buprenorphine hydrochloride) and Suboxone (buprenorphine hydrochloride and naloxone hydrochloride). Both of these medications are given in the form of sublingual tablets, meaning you place the tablet under your tongue and let it dissolve. Other formulations of buprenorphine, such as Buprenex, an injectable formulation for pain relief, are not approved to treat addiction.

Treatment consists of several days of induction (introducing the drug), during which patients take buprenorphine in the presence of a doctor, followed by a maintenance phase for as long as necessary. During induction, the doctor can monitor the patient to ensure compliance as well as to adjust dosages as necessary.

Induction may take place on either an inpatient or outpatient basis. Outpatients must return to the doctor's office daily, and may be required to pick up daily doses of medication from the pharmacy before seeing the doctor. Subutex is often used during the induction phase because patients tend to tolerate it better initially.

Suboxone is the preferred formulation for maintenance dosing. The naloxone in this formulation discourages dissolving the tablet and injecting it, because injected naloxone blocks the effects of opioids, which can lead to severe withdrawal symptoms. When the tablet is dissolved under the tongue, very little naloxone gets into the body, so the buprenorphine can do its job.

Side Effects of Buprenorphine

Buprenorphine is generally safe when taken as directed. The most common side effects are:

  • Headache
  • Nausea
  • Insomnia
  • Sweating
  • Mood swings
  • Cold or flu-like symptoms

Additional side effects experienced by some patients include:

  • Pain, especially abdominal or back pain
  • Constipation
  • Infection
  • Anxiety
  • Depression
  • Withdrawal syndrome

Although buprenorphine is generally safe, severe complications have occurred, usually in patients who try to abuse it. Injecting buprenorphine, especially with benzodiazepines, can cause decreased respiration and even death. Patients who drink alcohol, continue to take other opioids, or take certain sedatives or antidepressants may overdose. Always inform any doctor treating you that you are addicted to opioids and are on buprenorphine treatment.

Buprenorphine Dependence

All opioid drugs carry some risk of dependence, but this risk is relatively low when buprenorphine is taken under medical supervision. If you stop treatment suddenly, you may experience severe withdrawal symptoms. Once your doctor has determined you can stop treatment, you will need to be weaned off the drug.

Where to Get Buprenorphine

Buprenorphine treatment for addiction is only available from doctors who have met certain qualifications and have notified the Secretary of Health and Human Services (HHS) that they intend to treat opioid addiction with buprenorphine. Doctors are limited in the number of patients they can treat at one time, so you may need to contact more than one.

Sources

Substance Abuse and Mental Health Services Administration. 14 May, 2009.
FDA/Center for Drug Evaluation and Research. 8 Oct. 2002. Subutex and Suboxone Information Page. 14 May, 2009.
Suboxone Website. 2007. 14 May, 2009.