The U.S. opioid crisis has claimed its spotlight across the news, medical schools, and government meeting tables since the U.S. Department of Health and Human Services declared opioid abuse a public health emergency in 2017.
This massive increase in opioid misuse saw its beginning in the 1990s, when some pharmaceutical companies convinced medical practitioners that opioid pain relief would not lead to addiction. We now know that this is wrong. Currently, over two million people have an opioid use disorder.
Combating Opioid Misuse
Luckily, synthetic medications have come out to help those who have developed an opioid dependency. One of these medications is called buprenorphine.
In 2002, buprenorphine became the first medication for the treatment of opioid abuse available with a prescription in physician offices.
While other medication-assisted treatments (MATs) for opioid addiction must be dispensed solely in structured rehabilitation facilities, buprenorphine provides an alternative that is more accessible for those visiting community health clinics, attending a regular checkup at their doctor’s office, or serving time within correctional facilities.
How it Works
Buprenorphine is a partial opioid agonist, binding less strongly to the body’s opioid receptors than a full agonist (such as heroin.) As a result, buprenorphine can be substituted in order to reduce withdrawal symptoms and safely treat opioid addiction. A doctor will give buprenorphine in smaller and smaller doses until the end of the prescription’s course. This “tricks” the body into eliminating opioid dependence without a serious withdrawal period.
This opportunity for fewer withdrawal symptoms makes addiction treatment easier for patients while also allowing them to focus on behavioral aspects of their therapy, which is generally done along with the medication, ensuring that they will be less likely to relapse in the future.
While buprenorphine is the generic name for this medication, you’re also likely to see buprenorphine referred to by a number of trade names, depending on its form. You may see the following differently-named formulations:
This liquid formulation contains a set concentration of buprenorphine and was designed for injectable use. A healthcare provider may choose to inject Buprenex into a muscle or directly into the bloodstream.
Designed specifically as a treatment for opioid addiction, Subutex was developed as a tablet to be placed beneath the tongue until fully dissolved. The medication crosses the mucosal surface beneath the tongue, entering the bloodstream and doing its work.
In some cases, doctors may prescribe Butrans, a patch placed on the skin which provides a steady dose of buprenorphine as long as the patch remains on the skin.
The newest form of buprenorphine available, Belbuca, is a form of buprenorphine developed as a “buccal film,” meaning that it is designed for placement on the inside of the cheek.
• Bunavail, Suboxone, and Zubsolv
These three medications use buprenorphine with another drug called naloxone. These buprenorphine and naloxone combination drugs come in tablets, sublingual films, or buccal films. I will discuss this medication combo in more detail in a future post.
As the war against opioid addiction and dependence rages on, buprenorphine (in its many forms) is likely to remain a powerful tool which makes the treatment of opioid dependence safer, more accessible, more comfortable, and more effective.