SUBOXONE (BUPRENORPHINE) TREATMENT
What is Suboxone?
“Suboxone,” is a term frequently used to collectively refer to medications that contain the compound buprenorphine. However, Suboxone is but one of several different medications that all contain this specific compound. Currently, medications within this group targeted at opioid addiction are Suboxone, Subutex, Zubsolv, Bunavail, Sublocade, Probuphine, and generic versions of these.
What is Buprenorphine?
Buprenorphine is a synthetic opioid medication used in the treatment of opioid dependence. It is available in various forms, including sublingual (under the tongue) tabs and strips. Compared with many other opioids, buprenorphine is quite powerful, requiring small doses to be effective. Some physicians are now using buprenorphine even to treat pain.
How Does it Work?
Buprenorphine binds to, and affects, the body’s opioid receptors in a variety of ways. These receptors are involved in many important functions and perceptions, such as breathing, perception of pain, feelings of well-being, feelings of anxiety, and others. Unlike full opioid agonists such as heroin, oxycodone, and morphine, buprenorphine is a partial opioid receptor agonist. By only partially activating a neurochemical response, its effect is less intense than other opioids. Though buprenorphine is only a partial agonist, it has a very high affinity for the opioid receptors. In other words, buprenorphine “attaches” very strongly to the opioid receptors but does not “do” as much as other opioids once it arrives. Other opioids already present at receptor sites may even be displaced upon administration of buprenorphine, due to its extremely high binding affinity. Once present at the receptor site, buprenorphine may block the effects of other opioids until the body metabolizes the medication.
How is Buprenorphine Used in the Treatment of Opioid Addiction?
Buprenorphine is used as a drug replacement therapy, both short- and long-term. Patients must wait for the onset of moderate withdrawal symptoms to begin before starting a buprenorphine treatment schedule because taking buprenorphine too early in the withdrawal phase will lead to an unpleasant “precipitated withdrawal.” Once moderate withdrawal symptoms begin, the patient takes buprenorphine as prescribed by their physician. Buprenorphine then alleviates the withdrawal symptoms and stabilizes the individual, thus allowing them to pursue counseling and other therapies suitable for their treatment needs.
Is Buprenorphine Right for Me?
Buprenorphine exhibits some characteristics which give it advantages over other opioids for the treatment of opioid dependence by drug replacement therapy. In opioid-dependent patients, buprenorphine rarely elicits euphoria at any dose. This is a desirable property, given that euphoria is an important component of the cycle of dependence. Additionally, the drug exhibits less respiratory depression than many other opiates. Furthermore, buprenorphine exhibits a phenomenon is known as the “ceiling effect,” which gives buprenorphine a greater safety profile relative to many other opioids.
Unlike methadone, which requires frequent clinic visits to receive a dose, buprenorphine may be prescribed by a licensed physician, filled at a local pharmacy, and taken home. Research demonstrates that buprenorphine is an effective maintenance therapy for opioid dependence. Its pharmacological and logistical differences from other opioid replacement therapies make it an attractive treatment option for some patients.
However, buprenorphine is not appropriate for all patients and should only be taken under the care of a licensed physician. Some patients are better treated using methadone or undergoing other therapies. Please feel free to contact us any time to discuss.