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Buprenorphine Addiction And The Best Rehab Centers For Treatment

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 19, 2019

Buprenorphine is a prescription painkiller as well as a medication used to treat opioid addiction. Despite this latter use, however, buprenorphine in its numerous forms may itself be abused and become addictive.

What Is Buprenorphine?

Buprenorphine is used within the United States as a narcotic analgesic (an opiate painkiller) but perhaps its most widely recognized use is as a treatment for opioid addictions. Unfortunately, in strict opposition to the latter, intended use, some individuals actually abuse buprenorphine in a capacity that forges an addiction. Abuse may result in a loss of quality of life, addiction, overdose, and in certain cases, death.

Buprenorphine is a semi-synthetic opiate partial agonist derived from thebaine, a constituent of opium. As a partial agonist, this drug yet produces the euphoria and respiratory depression that is associated with opioids, however, to a lesser extent. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), another safeguard of buprenorphine is that it has a “ceiling effect,” meaning the “opioid effects increase with each dose until at moderate doses they level off, even with further dose increases.” Combined, these properties decrease the potential for abuse, dependency, and side effects, and actually increase the measure of safety should an overdose occur. Though the potential for abuse is lower, abuse may still occur, including more readily in those who do not have an opioid dependency, as elaborated by SAMHSA.

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How Is Buprenorphine Used As A Pain Reliever?

As an analgesic, buprenorphine is prescribed for two purposes: for either mild to moderate short-term or acute pain that can be treated as needed or for severe and chronic pain that requires around-the-clock treatment for a prolonged period of time. Buprenorphine is administered one of three ways, as a transdermal patch (a patch that is placed on the skin), under the brand name Butrans; as a buccal film which is placed inside a person’s cheek, by the brand name of Belbuca; or as an injection, by the brain name Buprenex. When this drug is used in this way, a smaller dose is required

How Is Buprenorphine Used For Opioid Addiction?

In 2002, the Food and Drug Administration (FDA) approved both Suboxone (a film and combination of buprenorphine and naloxone) and Subutex (pure buprenorphine) to be utilized as treatments for opioid addictions, however, as per the most recent changes to MedlinePlus, Subutex is no longer available on the market, however, it is noted that generic forms may still be available. In addition, Bunavail (a buccal film) and Zubsolv (sublingual tablets), also buprenorphine/naloxone combinations, are available.

When used for this purpose, within medication-assisted treatment, the dose of these medications is higher than the analgesic applications, and it is used in one of two ways, either as a medication within a medical detoxification from opioid drugs or used as a short- or long-term opioid replacement therapy, as it may block, in part, the effects of other opioid drugs.

Within the combination forms, naloxone is an opioid antagonist; used with buprenorphine it aids in preventing the diversion and abuse of buprenorphine. As explained by SAMHSA, if the sublingual tablet is used orally, “opioid effects dominate and naloxone blocks opioid withdrawals,” however, if these tablets are crushed and injected or snorted, naloxone may actually induce withdrawal.

Understanding Buprenorphine Abuse

Despite its current application within addiction medicine, and though this drug does not create the intense high or euphoric state that other opioids do, it does have a potential for abuse, and in some cases, addiction. According to the Drug Enforcement Agency, buprenorphine has “30 to 50 times the analgesic potency of morphine,” a fact that explains why this drug is gaining favor within the world of opioid drug abusers. Unlike methadone, another medication used for treatment of opioid addiction, buprenorphine may be prescribed by federally authorized doctors and taken at home by the individual. This wider availability of use may be one reason why this drug is abused. In terms of buprenorphine as a painkiller, these forms of the drug may also be abused, and in some cases form an addiction.

Known on the street as “Bupe,” “Subs,” or “Subbies,” there are a variety of ways a user may choose to abuse these drugs. In its pure form, buprenorphine is significantly more addictive, and may be abused orally, crushed and snorted, or crushed and liquefied prior to injection. Again, if a sublingual tablet is crushed and injected or snorted, a user may become violently ill as they experience symptoms of withdrawal, however, despite the adverse effects caused from naloxone, the Center for Substance Abuse Research (CESAR) does cite that tablets are often abused by snorting. The According to the Food and Drug Administration, “clinicians should be aware that some opioid-dependent persons, particularly those with a low level of full mu-opioid physical dependence or those whose opioid physical dependence is predominantly to buprenorphine, abuse buprenorphine/naloxone combinations by the intravenous or intranasal route.” Users may also abuse Bunavail or Suboxone films.

Study findings highlight that abuse may derive from various ways, as reported by CESAR. The publication details that injection drug users (IDUs) “were significantly more likely than non-IDUs to report using diverted buprenorphine/naloxone for self-medication reasons, such as to reduce withdrawal symptoms or to self-treat opioid addiction. In contrast, non-IDUs were significantly more likely than IDUs to report using diverted buprenorphine/naloxone to get high (69% vs. 32%).”

What Are The Side Effects Of Buprenorphine?

Like any drug of abuse, even prescribed drugs that are used illicitly—when a dosage is changed, as is characteristic of abuse, certain side effects may result or increase.

Side effects of buprenorphine may include:

  • cravings
  • nausea
  • small pupils
  • drowsiness
  • slurred speech
  • impaired coordination
  • insomnia
  • depression
  • irritability
  • respiratory depression
  • slowed heartbeat
  • hallucinations
  • withdrawal
  • coma
  • death

Though respiratory depression may not become as pronounced as with other opioids, it may still become dangerous, especially in instances of polysubstance abuse, a behavior of abusing more than one drug together, a practice that is altogether too common with many drug abusers. Speaking of Suboxone, CESAR cites the manufacturer’s safety information which asserts that it “can cause serious life-threatening respiratory depression and death, particularly when taken by the intravenous (IV) route in combination with benzodiazepines or another central nervous system (CNS) depressants (i.e., sedatives, tranquilizers, or alcohol).”

These damaging behaviors may very negatively impact a user’s life, as well as potentially causing overdose, coma, and even death—dangers that become more prevalent if this medication is used with other drugs that depress the central nervous system, such as alcohol, benzodiazepines, and other sedatives or tranquilizers. Fortunately, treatment is available. We strongly recommend inpatient drug rehab centers for concerns of buprenorphine or any other drug addiction. Various therapies, counseling, and other impactful treatment methods will be used to aid the addicted individual in finding sobriety.

How Is Buprenorphine Abuse And Addiction Treated?

Treatment for buprenorphine is similar to treatment for other opioid addictions. As symptoms of withdrawal can be very uncomfortable, we highly recommend that you never attempt to undergo them on your own. This may become unbearable and very risky, as some individuals resort back to drug abuse, as a way to temper these symptoms. To circumvent these risks, and to increase the measure of a person’s comfort, as a first step, in instances of addiction, an individual will likely undergo a medical detox. During this process, a person’s body is supported in removing the toxins accumulated from prolonged drug use. Medication-assisted treatment may be utilized at this time to address any symptoms, such as depression or anxiety, which may accompany withdrawal.

After a person successfully completes detoxification, the full spectrum of treatment will begin. If an individual is within the initial stages of buprenorphine abuse, or in limited instances of addiction, an outpatient program may be sufficient; however, when addiction is present in any form, we strongly urge you to seek the support of an inpatient drug rehab center. If an individual has an accompanying mental health disorder, termed a co-occurring disorder, inpatient treatment may be even more essential, as it will allow intensive and compassionate treatment for these dual diagnosis concerns.

Within inpatient treatment, a person will encounter a variety of effective methods, including various behavioral therapies, such as cognitive behavioral therapy or dialectical behavioral therapy. According to the National Institute on Drug Abuse’s “Principles of Drug Addiction Treatment: A Research-Based Guide,” contingency management interventions, motivational incentives, and twelve-step facilitation therapy (self-help groups) are effective strategies within an opioid treatment program. Additionally, a program may integrate individual and group counseling sessions, family programs, and outreach; pain management, for those who had concerns of pain that precluded buprenorphine abuse; nutrition guidance and support, relapse prevention and instruction of enhanced coping skills, aftercare support, and numerous other dynamic and engaging activities.

RehabCenter.net is here to support you, or your family member, in finding the resources and information that can make your treatment needs a reality. Contact us today and begin moving towards a drug-free life.

Center for Substance Abuse Research - CESAR FAX Special Series: Buprenorphine

Drug Enforcement Administration - Buprenorphine

MedlinePlus - Buprenorphine Transdermal Patch

MedlinePlus - Buprenorphine Buccal (chronic pain)

MedlinePlus - Buprenorphine Sublingual and Buccal (opioid dependence)

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