This section provides answers to common questions about Buprenorphine medication. See the bottom of this page for references and links. When using any information presented here, please include a backlink to the page and reference where applicable.
Table of Contents
Buprenorphine is a medication that can help people overcome their addiction to drugs like heroin or painkillers. As a partial opioid agonist, it activates the same parts of the brain as these drugs, but not as strongly. Therefore, it doesn’t make people as high and doesn’t cause as many problems with withdrawal.
Use in treatment
Buprenorphine is usually given to people in a program called outpatient medication-assisted treatment, or MAT. This program helps people stop using drugs by giving them medicine to help with withdrawal symptoms and cravings. Moreover, it teaches them how to change their behavior and thoughts around drugs.
One of the reasons that Buprenorphine is a helpful medication is that it is less risky than other drugs that people may use when they are addicted to opioids. Furthermore, it is less likely to be abused, which means people are less likely to get addicted to it.
When people take Buprenorphine, it can help them stop using drugs like heroin or painkillers by reducing their cravings and the withdrawal symptoms they experience when they stop using. Additionally, it can help them feel better overall and avoid getting diseases like HIV or hepatitis C.
Medication assisted treatment options with Suboxone
However, it’s essential to remember that Buprenorphine should only be used as part of a treatment plan that includes counseling and therapy. This is because addiction is about more than just using drugs. It’s about the way someone thinks and feels about themselves and the world around them. By working with a counselor or therapist, someone who is addicted to drugs can learn how to change their thoughts and behaviors so they can avoid using drugs in the future. Buprenorphine can help them feel better physically, but the counseling and therapy can help them feel better mentally and emotionally.
Detailed Overview: What is Buprenorphine?
Buprenorphine/Suboxone is a medication used in outpatient medication-assisted treatment (MAT) programs to help people recover from opioid and pain medication dependency or addiction. It is a partial opioid agonist, which means that it activates the same opioid receptors in the brain as opioids like heroin or fentanyl, but it does so to a lesser degree. This reduces the risk of overdose and withdrawal symptoms compared to full agonists like these drugs. This medication helps people to quit or reduce the use of illicit opiates such as heroin, methadone, fentanyl, and other pain relievers like morphine, oxycodone, etc.
When prescribed in addiction treatment programs, Buprenorphine is a safer alternative to full opioid agonists and is less abused. Buprenorphine is often used in combination with naloxone, an opioid antagonist, which further reduces the risk of overdose and abuse. Buprenorphine can help reduce cravings and withdrawal symptoms, and it can also improve social functioning and reduce the risk of contracting infectious diseases like HIV or hepatitis C. It is important to note that Buprenorphine should be used as part of a comprehensive treatment plan that includes counseling and behavioral therapy9.
Who is it for?
Professional Buprenorphine treatment offers numerous benefits over a methadone clinic or self-medicating as it is more controlled and convenient. Patients enrolled in a substance use treatment program reportedly have more time for productive activities such as education and parenting; once stabilized on buprenorphine, people had experienced increased employment, community engagement, and better health and well-being6.
Buprenorphine medication is often prescribed in an outpatient addiction treatment center, clinic, or medical office with appointment frequency as suggested by the medical provider; it can range from a few days to multiple weeks. Substance use treatment with buprenorphine allows for much more flexibility than alternative methadone maintenance programs. Combined with behavioral services and counseling, this outpatient type program can be a comprehensive solution and an answer to drug addiction recovery.
Benefits of outpatient recovery treatment:
- Receive treatment while living at home;
- Allows for more time to work and go to school;
- Spend more time with your family and friends;
- Tailored programs to individuals’ needs;
- Affordable compared to inpatient addiction recovery treatment;
- Most insurances cover substance use treatment at low cost to patients.
Opioid Addiction Treatment with Buprenorphine
To begin outpatient treatment for opioid use disorder, a patient should not have used opioids or opiates at least 12-24 hours before their appointment. The patient also needs to be in the early stages of opioid withdrawal. Otherwise, when taking medication the patient may experience acute withdrawal symptoms.
The Buprenorphine dosage may be adjusted by the provider once the patient is stabilized on the medication: discontinued or greatly reduced opioid use, no cravings, and is experiencing a few to no side effects.
See How to Get Started? page for more info about your first appointment.
Who can prescribe
Providers must complete special training and receive X-waiver certification to prescribe buprenorphine for opioid dependency treatment.
How does it work?
The medication lowers the harms associated with opioid/opiate misuse and gives people a chance to stabilize their lives1. Buprenorphine works by “blocking” the effects of other opioids at the opioid mu-receptor which is responsible for opioids’ pleasurable effects and their ability to relieve pain*6. Buprenorphine effects last longer than short-acting opioids such as heroin, oxycodone, fentanyl, morphine, or hydromorphone1. After consumption, buprenorphine is broken down by the liver and processed through kidneys.
*Please note, buprenorphine is not a recommended medication for pain relief.
What are the effects?
Buprenorphine is an opioid partial agonist meaning it produces similar but weaker effects to heroin, fentanyl, and methadone which are full opioid agonists. The medication prevents opioid withdrawal symptoms and reduces drug cravings. Buprenorphine opioid effects increase with continuous use until they level off at moderate levels, even if the dose increases8. Buprenorphine products are long-lasting and patients should consult with their provider on the appropriate daily dosage.
Please note, self-tapering might not be appropriate for some patients and the dosage reduction is best to be observed with your provider to avoid challenging withdrawal symptoms. You should contact your provider in order to make changes to your treatment plan to ensure a successful outcome.
How long does Suboxone stay in your system?
The length of time that Suboxone (a brand name for a medication containing buprenorphine and naloxone) stays in your system can vary depending on several factors, such as your age, weight, liver function, and frequency of use.
Generally, Suboxone can be detected in urine for up to 3-4 days after the last dose. It can be detected in blood for up to 24 hours after the last dose. In hair, it can be detected for up to 90 days or longer after the last dose, depending on the length of the hair sample.
Buprenorphine side effects
Buprenorphine side effects are similar to those of opiates but are associated with less physical dependence; it also has more mild withdrawal syndrome if discontinued5. Here is a list of side effects as reported by SAMHSA :
|Common side effects of buprenorphine include:||Serious side effects of buprenorphine include:|
|Constipation, headache, nausea, and vomiting|
Drowsiness and fatigue
Muscle aches and cramps
Inability to sleep
Blurred vision or dilated pupils
Disturbance in attention
Itching, pain, swelling, and nerve damage (implant)
Pain at injection site (injection)
Neonatal abstinence syndrome (in newborns)
Buprenorphine has many pharmacologic and clinical advantages over other opioids. Comparingly, cognitive impairment is less frequent, and sexual effects are less prominent. The medication also has less impact on physiological processes such as metabolism, immune responses, and the autonomic nervous system than other opioids5.
Misconceptions about Suboxone
Misconception #1: Suboxone is just another opioid, so it has the same side effects as other opioids.
Reality: While Suboxone contains an opioid component, it’s formulated to minimize the typical euphoria and respiratory depression associated with other opioids. Therefore, its side effects are generally milder.
Misconception #2: Being on Suboxone means you’re not truly in recovery.
Reality: The traditional abstinence-based recovery models from decades ago are evolving. Modern views of recovery recognize that medications like Suboxone, which regulate brain chemistry, are valid tools. Addiction is increasingly seen as a medical condition, and Suboxone is likened to medication for chronic conditions, much like insulin for diabetes. Claiming that Suboxone negates recovery stigmatizes those who benefit from it and doesn’t align with effective addiction treatment’s medical reality.
Misconception #3: Suboxone causes severe withdrawal symptoms if stopped suddenly.
Reality: Suboxone is designed to help manage opioid withdrawal symptoms. However, abruptly stopping any medication, including Suboxone, can lead to withdrawal symptoms. It’s recommended to work with a healthcare provider to taper off Suboxone gradually.
Misconception #4: Suboxone causes addiction and dependence just like other opioids.
Reality: Suboxone is used as a part of medication-assisted treatment (MAT) to help individuals reduce cravings and withdrawal symptoms, allowing them to focus on recovery. When taken as prescribed under medical supervision, the risk of addiction is significantly reduced.
Misconception #5: Suboxone side effects are severe and unbearable.
Reality: While Suboxone can have side effects like any medication, they are generally mild and manageable. Common side effects include nausea, headache, and constipation. Most side effects tend to improve as the body adjusts to the medication.
Misconception #6: Suboxone causes permanent damage to the body.
Reality: Suboxone, when used as directed and under medical supervision, is considered safe. While there might be some side effects, they are usually temporary and not associated with long-term damage.
Misconception #7: Suboxone negatively affects mental health and cognitive function.
Reality: Suboxone is not known to cause significant mental health issues or cognitive impairment. However, everyone’s response to medication can vary. It’s important to discuss any concerns with a healthcare provider.
Misconception #8: Suboxone causes weight gain.
Reality: Weight gain is not a common side effect of Suboxone. Any changes in weight may be due to other factors like lifestyle, diet, or underlying health conditions.
Misconception #9: Suboxone is only for detox and not for long-term maintenance.
Reality: Suboxone is used both for short-term detoxification and for long-term maintenance to manage opioid use disorder. It can be part of a comprehensive treatment plan that includes counseling and therapy.
Misconception #10: Overdosing on Suboxone is equally easy as with other opiates.
Reality: Overdosing on Suboxone alone is highly unlikely. Unlike potent opiates, Suboxone is a partial opiate receptor agonist, with a natural “ceiling” effect that limits receptor activation. This significantly reduces the risk of slowed breathing. Most Suboxone overdoses result from combining it with sedatives like benzodiazepines, which also depress breathing. The difficulty of overdosing on Suboxone makes it distinct from potent opiates like heroin, oxycodone, or morphine.
Buprenorphine has opioid effects and it can be misused if taken without a physician’s guidance or by people without an opioid dependency. In Suboxone, Zubsolv, and Bunavail medications the Naloxone component is added to decrease the potential misuse. When taken as prescribed*, Naloxone blocks opioid withdrawals.
*Buprenorphine sublingual tablets should never be crushed as it won’t work otherwise (AmericanAddictionCenters).
When taking Buprenorphine medication (with or without Naloxone) it is important to follow some precautions. Consult with your provider if you have other medications; do not mix it with illicit drugs, alcohol, sedatives, or tranquilizers; ensure your doctor monitors your health, specifically liver-related issues that can arise8. Mixing Suboxone or other buprenorphine products with benzodiazepines or alcohol can lead to an overdose or death.
It is important to take buprenorphine in the prescribed dosage to avoid potential withdrawals. Also when the prescribed medication dissolves in the mouth, patients should be aware of potential dental problems. After the medication is dissolved, patients should swoosh gently the water in their mouth and swallow; wait at least an hour before brushing their teeth not to damage them and let the mouth return to its normal state4.
For Pregnant and Breastfeeding Women
Buprenorphine is one of the options for pregnant and breastfeeding women that are diagnosed with opioid use disorder. Evidence shows that buprenorphine is equivalent to methadone in managing OUD during pregnancy7. It is important to note that Buprenorphine produces a less severe neonatal syndrome than methadone which can have negative effects on newborns.
It is best to coordinate MAT care with behavioral therapy and other medical providers to ensure the health of the mother and the baby. Buprenorphine-naloxone such as Suboxone appears to be safe for treating women during pregnancy. Transitioning to a different opioid agonist might not be necessary as it has a greater misuse potential2. In some instances, the medical provider might transition a patient to Subutex, the Buprenorphine medication without the Naloxone component.
Suboxone Withdrawal Symptoms
If a person was exposed to heavy drug use and then significantly cut back or abruptly stopped their use will experience symptoms of withdrawal. Suboxone withdrawal although milder but still similar to heroin withdrawal; a person might experience3:
- Increased sweating
- Nausea and Vomiting
- Frequent mood changes
- Abdominal cramping
Buprenorphine Brand Names and Formulations
Buprenorphine is often prescribed to take sublingually for opioid addiction treatment. The medication peaks concentration in 40 minutes to 3.5 hours with a drug elimination half-life of 4-6 hours for your body to process half of the active substance5. Sublocade opioid blocker injections are usually given once a month with at least 26 days in between. The urine drug tests for substance use can detect orally taken buprenorphine for up to two weeks depending on the concentration and Sublocade can be traced for up to twelve months from the administration.
There are currently a number of FDA-approved buprenorphine medications on the US market for treating opioid use disorder9:
- Generic Buprenorphine-Naloxone* sublingual tablets
- Subutex*: Buprenorphine sublingual tablets
- Suboxone*: Buprenorphine-Naloxone sublingual films
- Zubsolv*: Buprenorphine-Naloxone sublingual tablets
- Bunavail*: Buprenorphine-Naloxone buccal film
- Probuphine: Buprenorphine implants
- Sublocade: Buprenorphine extended-release injection
*Oral products are designed to be dissolved; chewing or crushing them will not work as well.
Buprenorphine treatment has alternatives that might suit some individuals based on their level of care needs.
Buprenorphine and Methadone are both effective at reducing illicit opioid use and withdrawal symptoms. Despite being similar in this regard, Methadone is required to be taken under direct supervision as its a full opioid agonist. Buprenorphine is a partial opioid agonist, is safer, and can be more convenient as it requires less frequent appointments
Naltrexone treatment for opioid use disorder might not be as effective as it requires full detoxification which might be hard due to the withdrawal symptoms and cravings. However, after the detoxification completion, the Naltrexone injections could produce similar effects for some patients as Buprenorphine-Naloxone medications.
Why choose Suboxone treatment over the alternatives?
When it comes to medication-assisted treatment (MAT) for opioid addiction, Suboxone is often considered the best medication for long-term recovery. Suboxone is a brand name formulation of Buprenorphine and naloxone, which work together to reduce withdrawal symptoms, cravings, and the risk of overdose.
Compared to other medications used in MAT programs, Suboxone has several advantages that make it an excellent choice for people seeking treatment for opioid addiction.
One of the primary advantages of Suboxone is that it has a lower risk of abuse and overdose compared to other medications used in MAT programs, such as methadone. Suboxone contains Buprenorphine, a partial opioid agonist that activates the same opioid receptors in the brain as full opioids but to a lesser degree. This makes it less likely to be abused and less risky than full opioid agonists like methadone or fentanyl. Additionally, Suboxone contains naloxone, an opioid antagonist that further reduces the risk of abuse and overdose by blocking the effects of opioids.
Another advantage of Suboxone is its convenience. Suboxone can be prescribed by a doctor in an office setting, and people can take it at home or wherever they are without needing to go to a clinic every day. This makes it easier for people to access the care they need and reduces the stigma associated with addiction treatment.
Compared to methadone, which is typically taken daily, Suboxone has a longer half-life and can be taken every other day or even every few days. This makes it more convenient for people who have busy schedules or who live far away from a clinic.
Suboxone also has fewer side effects compared to methadone. While both medications can cause constipation, headaches, and nausea, these side effects are generally milder with Suboxone and go away on their own. Additionally, Suboxone is safe for pregnant and breastfeeding women, making it an excellent option for women who are struggling with opioid addiction.
In conclusion, Suboxone is a safe and effective medication that can help people recover from opioid addiction. It has a lower risk of abuse and overdose compared to other medications used in MAT programs, is more convenient to use, has fewer side effects, and is safe for pregnant and breastfeeding women. If you or someone you love is struggling with opioid addiction, Suboxone may be an excellent option to consider.
Importance of Behavioral Therapy in Substance Use Treatment
Behavioral and Mental Health Therapy is an important component of a comprehensive treatment plan. It allows providers to create a personalized approach for the patient’s success in recovery.
While Suboxone can be an effective medication for treating opioid addiction, it is important to note that medication-assisted treatment (MAT) should be combined with behavioral therapy to achieve the best outcomes. Behavioral therapy, such as cognitive-behavioral therapy (CBT) and contingency management (CM), can help people develop the skills and coping mechanisms they need to maintain their recovery long-term.
At New Horizons Medical, we offer a confidential and safe environment where patients receive supportive counseling services in individual, group, couples, and family formats. Participating in counseling is a major step toward creating a balanced and healthy lifestyle.
One of the primary benefits of behavioral therapy is that it helps people identify and address the underlying issues that may have led to their addiction in the first place. This can include issues like trauma, mental health disorders, or unhealthy coping mechanisms. By addressing these issues in therapy, people can develop healthier ways of managing stress and avoiding relapse.
Another benefit of behavioral therapy is that it can help people develop stronger social support networks. This is particularly important for people in recovery, as social isolation can be a major risk factor for relapse. In therapy, people can learn how to build and maintain healthy relationships and develop a support system of people who understand what they are going through.
Behavioral therapy can also help people learn how to manage cravings and triggers more effectively. This can be particularly helpful for people taking Suboxone, as cravings and triggers can still occur even while on the medication. By learning how to manage these feelings and situations, people can reduce their risk of relapse and maintain their recovery long-term.
Buprenorphine with Naloxone is a medication used to help people recover from opioid addiction. It’s a partial opioid agonist, which means that it activates the same opioid receptors in the brain as opioids, but to a lesser degree. Buprenorphine is typically prescribed in outpatient medication-assisted treatment (MAT) programs that combine medication and therapy to help people quit or reduce the use of illicit opioids like heroin or prescription pain relievers.
Compared to other full opioid agonists like heroin or fentanyl, Buprenorphine is less risky and less likely to be abused. It can help reduce cravings and withdrawal symptoms, improve social functioning, and reduce the risk of contracting infectious diseases like HIV or hepatitis C. However, it should only be used as part of a comprehensive treatment options that includes counseling and behavioral therapy.
Buprenorphine can have side effects, including constipation, headache, and nausea, but it is generally considered safe, even for pregnant and breastfeeding women. There are several brand names and formulations of Buprenorphine available, including Suboxone, Zubsolv, and Bunavail.
Methadone and Naltrexone are other medications used in MAT programs for opioid addiction, but they work differently than Buprenorphine. Methadone is a full opioid agonist, while Naltrexone is an opioid antagonist, which blocks the effects of opioids.
It’s important to note that addiction is about more than just using drugs; it’s about the way someone thinks and feels about themselves and the world around them. That’s why behavioral therapy is crucial in substance use treatment, whether someone is using Buprenorphine or another medication.
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- Dooley MD, J., Gerber-Finn MD, L., Antone MD, I., Guilfoyle MD, J., & Blakelock MD, B. (2016, April). Buprenorphine-naloxone use in pregnancy for treatment of opioid dependence: Retrospective cohort study of 30 patients. NCBI. Retrieved October 12, 2022.
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- Harvard Health Publishing, October 7, 2021, 5 myths about using Suboxone to treat opiate addiction. Retrieved August 28, 2023.