There are many approaches to addiction treatment. Medication-assisted treatment (MAT) uses medications to help those in recovery avoid the health conditions associated with withdrawal and minimize the risk of relapse. Buprenorphine is one of the medications that is typically included in a MAT program. As with many prescription medications, buprenorphine can cause unwanted side effects, especially if the medication is misused.
Buprenorphine was developed in the 1960s and was originally intended to be used as an alternative to morphine for pain relief. By that time, the addictive properties and unwanted side effects of morphine were well known, and medical science was looking for a more suitable medication to help people with pain management. Buprenorphine is a schedule III drug, meaning it carries a low to moderate risk for physical dependence and a high risk for psychological dependence.
Buprenorphine is a partial opioid agonist. It binds with the same brain receptors — known as opioid receptors — as other types of opioids, including heroin. However, it does not produce the same intense feelings of euphoria as other opioids. During clinical testing, researchers discovered that buprenorphine could be helpful in the treatment of narcotic addiction, but the drug was not FDA-approved for this purpose until the early 2000s.
Today, buprenorphine is typically combined with naloxone to create a brand-name medication known as Suboxone. Suboxone is one of the most commonly used medications in MAT programs for the treatment of opioid and alcohol use disorders.
Other brand names for buprenorphine or buprenorphine-combination medications include Bunavail and Zubsolv.
MAT programs for both alcohol use disorder and opioid use disorder may prescribe buprenorphine as part of a comprehensive treatment plan that includes counseling therapies and other traditional modalities.
In the case of opioid addiction, buprenorphine works as a type of opioid replacement. It blocks more dangerous types of opioids from fully reacting with brain receptors, preventing the euphoric feelings produced by heroin, morphine, and other opioids. At the same time, the medication decreases the side effects of withdrawal, including the intense cravings that make it difficult for so many highly motivated recovery patients to resist relapse.
Buprenorphine is typically combined with naloxone (the generic name for the brand-name drug Narcan) which reverses the effects of narcotic drugs. Together, the two medications are known as Suboxone. By preventing or minimizing withdrawal symptoms and protecting individuals from fatal overdoses, Suboxone has become one of the most powerful tools in the fight against the opioid epidemic.
Buprenorphine works similarly when treating alcohol addiction. It reduces both the cravings for alcohol and the symptoms of alcohol withdrawal, which can be severe for some people. Typically, MAT is recommended for people with severe and prolonged alcohol use disorder. Withdrawal symptoms associated with severe alcohol addiction can be physically and psychologically painful and even life-threatening. They can include seizures, hallucinations, and delirium tremens.
Buprenorphine is typically administered as a dissolving sublingual (under the tongue) film or in tablet form. It must be prescribed by a doctor and in some cases, it must be dispensed at a doctor’s office or rehab clinic. Each person’s treatment plan is individualized to their needs, but the medication is commonly taken twice a week.
Other formulations are also available. An injectable form of Suboxone called Sublocade requires just a single monthly dose.
While buprenorphine eases withdrawal symptoms and reduces the risk of relapse, naloxone is an important component of Suboxone because it reverses and blocks the dangerous effects of opioids.
The Centers for Disease Control and Prevention reports that there were over 107,000 drug overdose deaths in the U.S. in 2021. Deaths due to opioid overdose have been increasing since 2020. Including naloxone as part of a regular medication program can save the life of a person who relapses while receiving treatment.
Overdose is the most dangerous side effect of opioid withdrawal. Once the body has detoxed itself from opioids, the dose it had once grown used to may become deadly. Individuals with opioid use disorder (OUD) can easily take a dose of heroin or OxyContin that was once tolerable, but because the system is no longer accustomed to metabolizing the drug, that same dose can now be enough to kill them. Naloxone may reverse opioid overdose symptoms.
Naloxone may also be included in MAT for alcohol use disorder. It blocks alcohol from affecting the brain and minimizes withdrawal symptoms, including reducing cravings.
Medication-assisted treatment is a well-researched, FDA-approved treatment for opioid addiction. It is recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA) and several other respected health organizations. Unfortunately, that doesn’t mean that buprenorphine addiction treatment does not pose its own risks.
As partial opioid agonists, buprenorphine and Suboxone are potentially addictive. However, the risk of addiction is much lower than with other types of opioids. As part of a comprehensive addiction treatment plan, buprenorphine supports the slow, safe withdrawal from more dangerous opioids. Rehab patients can stabilize their physical and mental health while working to heal relationships and rebuild their lives on other levels.
Buprenorphine has what is sometimes referred to as a “ceiling effect.” This means that even if a person takes larger or more frequent doses than recommended, they cannot increase the effects of the drug, so there is little motivation to misuse it. However, it is still possible to misuse and become addicted to buprenorphine.
Suboxone and buprenorphine are available through illegal drug trafficking. Because these substances provide only mild effects, they are more likely to be used by people struggling with opioid addiction who want to ease their withdrawal symptoms or protect themselves from a fatal overdose than those who are interested in getting high.
While addiction is unlikely, buprenorphine may cause the following short-term side effects in some people:
Drinking alcohol or using other substances while using buprenorphine may cause serious and even life-threatening side effects.
The long-term effects of buprenorphine addiction can be serious and include the following:
If a person is obtaining buprenorphine illegally, there are also legal and financial side effects to consider. Addiction of all kinds can result in destroyed relationships, job loss, loss of self-esteem and personal confidence, and potential legal consequences. When buying illegal drugs, there is also the risk of ingesting a substance that has been laced with unknown components. This increases the risk of overdose from dangerous drug interactions.
When used correctly in a MAT program, patients experience little, if any, withdrawal symptoms. After a period of maintenance, which can last several months or several years, a tapering-off schedule will begin. During this period, the dosage of buprenorphine (or Suboxone) is reduced weekly over a period of about 60 days. This slow and steady method supports the patient’s well-being and helps prevent the possibility of relapse.
If the drug is being abused, or if a person decides to quit taking the medication all at once, withdrawal symptoms may occur. They can include:
All opioids affect the brain, and those effects may differ for each person. The longer a person has used buprenorphine, the better adapted their body will be to the substance, and the more difficult withdrawal may be. The amount of buprenorphine being used and the length of the abuse are other factors that influence the severity of withdrawal symptoms.
Overdose is possible with buprenorphine. However, a fatal overdose is unlikely unless other dangerous substances are combined with buprenorphine. Any substance that is classified as a sedative, including prescription or over-the-counter sleep medications, increases the risk of overdose. Benzodiazepines, like Valium, are extremely dangerous to combine with buprenorphine because they also depress the respiratory system.
Symptoms of buprenorphine overdose may include:
In severe cases, a buprenorphine overdose can lead to respiratory depression, coma, brain damage, and death. If you suspect someone has overdosed on buprenorphine, Suboxone, or any other substance, call 911 immediately and stay with the person until help arrives.
All treatments that are approved for other types of opioid use disorder can be effective for treating buprenorphine addiction. If a person became addicted to buprenorphine as a result of medication-assisted treatment or because they were trying to manage their own opioid withdrawal illicitly, they may not be a good candidate to participate in a medication-assisted treatment program. However, each person’s situation is different, and only an evaluating physician can make that determination.
Detoxing is an important first step in the treatment process and may require medical supervision in an inpatient setting. During supervised detox, healthcare professionals monitor a patient’s symptoms and provide targeted therapies to keep them safe and comfortable during the detox process.
Inpatient treatment is typically recommended for buprenorphine detox. Inpatient (residential) programs not only manage the symptoms of withdrawal, but they also provide accountability and help patients begin to prepare for the next steps in addiction treatment.
Other therapies that may be used to help treat buprenorphine addiction include:
Learning to manage stress and strengthening other everyday coping skills are integral parts of any addiction treatment program.
Opioid use disorder is a life-threatening disease that can be treated successfully. People seeking help for OUD should not be afraid of using buprenorphine or Suboxone, but these medications do present a health risk if misused. Fortunately, buprenorphine addiction treatment is available and effective.
If you have a morphine addiction or any type of buprenorphine, getting help is essential. Lakeview Health offers individualized programs to tackle your unique challenges and circumstances. With state-of-the-art facilities and the latest techniques for helping people with substance use disorders, Lakeview Health can help you get back on the right path. Contact Lakeview Health today at 866.704.7692 .
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