Description
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Doctors use buprenorphine to manage severe pain when other treatments prove inadequate. Marketed under brand names like Suboxone, this opioid helps treat opioid addiction, acute pain, and chronic pain. Patients can take it sublingually (under the tongue), via injection, as a skin patch, or as an implant.
For opioid addiction treatment, healthcare providers initiate buprenorphine only after withdrawal symptoms begin and monitor the patient closely during the first 48 hours. For long-term addiction management, doctors prefer the buprenorphine/naloxone combination (Suboxone) to deter misuse through injection. The drug reaches peak pain relief within an hour, with effects lasting up to 24 hours.
Uses
Doctors prescribe buprenorphine to treat opioid dependence/addiction. As a mixed opioid agonist-antagonist, this medication helps patients avoid withdrawal symptoms when discontinuing other opioids. Healthcare providers incorporate it into a comprehensive addiction treatment program, which typically includes:
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Compliance monitoring
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Counseling
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Behavioral contracts
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Lifestyle modifications
Limitations of Use
Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses reserve buprenorphine for use in patients for whom alternative treatment options [e.g., non-opioid analgesics or opioid combination products]:
- Have not been tolerated, or are not expected to be tolerated
- Have not provided adequate analgesia, or are not expected to provide adequate analgesia
Side Effects
Side effects may include respiratory depression (decreased breathing), sleepiness, adrenal insufficiency, QT prolongation, low blood pressure, allergic reactions, and opioid addiction. Among those with a history of seizures, there is a risk of further seizures. Opioid withdrawal following stopping buprenorphine is generally less severe than with other opioids. It is unclear if use during pregnancy is safe and use while breastfeeding is not recommended. Buprenorphine affects different types of opioid receptors in different ways. Depending on the type of receptor it may be an agonist, partial agonist, or antagonist.
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