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Buprenorphine was discovered in 1966 and was approved by the FDA for MOUD use in 2002. If you want to read more about the history of buprenorphine becoming an OUD therapeutic, go here: The history of the development of buprenorphine as an addiction therapeutic
It is a partial opioid agonist. Here is a video on how buprenorphine can work on the brain.
Buprenorphine helps you feel normal, not high. It works by letting the brain think that it is receiving opioids, thus reducing withdrawal symptoms and cravings.
Can be combined with Naloxone in medications like Suboxone, which when injected can prevent opioids from working.
Buprenorphine helps you think and function normally. It is legal and taken under a doctor’s care.
Buprenorphine is produced under safe conditions and sold legally. There is no risk of getting tainted doses, which can happen with street drugs. Also, risk of overdose on this medication is very small.
Yes you can stop taking Buprenorphine when you are ready. You can become dependent on Buprenorphine, as with many medications taken over time. There is nothing wrong with remaining on buprenorphine treatment for many years. However, if you if you wish to stop taking Buprenorphine, you should work with a substance use treatment provider to taper off. This prevents withdrawal symptoms from appearing.
Dr. John Mariani, a Providers Clinical Support System Clinical expert, gives a patient an idea of how she will feel once she begins taking buprenorphine for the treatment of opioid use disorder.
How is it taken?
Buprenorphine is sublingual, meaning it needs to be dissolved under the tongue for it to be effective and properly absorbed.
Needs to be taken 6 hours, but suggested 12 hours, after last heroin use and 24 hours after last methadone use as it can precipitate opioid withdrawal if it contains naloxone.
You need to feel withdrawal before starting
Buprenorphine can also be taken as an injectable medication that can last 30 days or can also be an implant.
Check out this short video about buprenorphine and how it works.
How long should I be on buprenorphine?
Buprenorphine can be used to help detox from opioids. For long term-treatment, it should be typically taken for 3 to 6 months or sometimes up to 2 years.
Dependent on the person and their needs when it comes to treatment. You can take it for however long you need it to prevent a relapse.
However, it is best to consult your prescribing physician on what length of time is best for you.
How often do you take it?
Usually, buprenorphine is taken once a day. It can last up to three days. It is best to work with your doctor for a customised dose.
Is it toxic?
Suboxone has a low toxicity. In people with existing liver issues, the organ may become more impaired. However, this is extremely rare in people who have a healthy liver.
Can I overdose on it?
You are unlikely to overdose on it if you take it properly and as prescribed.
Instead, it has been shown to reduce the risk of overdose and death.
Can I take other medication while on it?
Always consult your doctor first before taking this medication.
Are there any side effects?
Like most medications, there are side effects. You might experience some discomfort or sickness, but these should subside after taking the medication for a while.
If you have side effects, do not stop taking the medications until you have consulted with your doctor. You might just need an adjustment in dosage or change in medication to help.
Place buprenorphine-with-naloxone sublingual film under the tongue and keep it there until completely dissolved (4–8 minutes on average).
Do not swallow, chew or move the film after it is placed under the tongue, as doing any of these makes the medicine less effective.
Do not eat or drink anything until the film is completely dissolved.
Do not inject buprenorphine-with-naloxone sublingual film. People are likely to experience strong opioid withdrawal symptoms from naloxone if they inject the medicine while still receiving other opioids. Also, people have developed blood clots, liver problems, and infections from injecting buprenorphine-with-naloxone tablets.
For people on a dose that requires more than one film:
Place no more than two films at a time under the tongue, taking care not to overlap them.
Wait until the first two films are completely dissolved before placing any additional ones.
Do not use any benzodiazepines (medicines used to treat anxiety or sleeping problems) unless prescribed. People have died from respiratory failure when using benzodiazepines at the same time as buprenorphine.
Do not take buprenorphine-with-naloxone sublingual film too close to other opioids, as it can cause withdrawal symptoms. Wait 6 hours or more after short-acting opioids (e.g. heroin, morphine, oxycodone) and wait 24 hours or more after methadone before taking buprenorphine with naloxone.
Buprenorphine-with-naloxone sublingual film can cause drowsiness, which is made worse by drinking alcohol or taking sedatives or anti-anxiety medicines.
Tell your doctor about all other medicines you are taking. Several medicines can change the effect of buprenorphine with naloxone, making it either less effective (e.g. some medicines for HIV) or increasing the risk of side effects (e.g. benzodiazepines, sedative antihistamines, antidepressants, antipsychotics).
There are some common misconceptions about buprenorphine. Chances are, if you have a question about it, that question has already been answered. Here are some resources that dispel these myths, along with some of the most common myths.
With many medications, you can become dependent on buprenorphine over time. If and when you wish to stop taking it, you should work with your doctor on a proper tapering protocol to prevent withdrawal symptoms. Tapering off buprenorphine is possible.
Buprenorphine is a medication for a chronic condition, opioid use disorder. Taking it is like taking insulin for diabetes. This language can stigmatize people from getting the help they need. Taking medication to maintain health is not a substance use disorder.
Buprenorphine, like other medications, can be misused. However, due to being a partial-agonist, it is less euphoric than other opioids. Some people may use buprenorphine to manage their withdrawal symptoms and self-treat when they cannot access the medications themselves.
Suboxone is a partial agonist and has a built-in ceiling effect, making it difficult to overdose on due to there being a limit to how much opioid receptors can be activated. When people do overdose on Suboxone, it is usually due to mixing it with sedatives, like benzodiazepines, that slow down breathing.
People on buprenorphine are not required to be in behavioral health services or therapy to receive the medication.
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