What is Buprenorphine (Suboxone)?

Buprenorphine is the active ingredient in both Suboxone and Subutex. It is a synthetic opiate and works as a partial opiate agonist in the brain.

As an opiate, buprenorphine has analgesic properties, but it is most commonly in America for the treatment of opiate addiction. People who are given buprenorphine for an addiction to opiates feel neither opiate withdrawal symptoms nor drug cravings while on the medication, and because of the way buprenorphine works in the brain, people taking the medication won't be able to use any other opiates to get high.

Buprenorphine, as a form of opiate substitution therapy has many similarities to methadone, but a couple of significant differences between the medications have led to buprenorphine's great popularity. The following are the biggest differences between buprenorphine and methadone:

  1. Doctors can prescribe buprenorphine in take-home doses.
  2. Buprenorphine withdrawal symptoms of less severe than methadone withdrawal symptoms.

Buprenorphine won't work for everyone, and some people are better served by entering a methadone maintenance treatment program. But many people have found buprenorphine an effective and very tolerable medication for an addiction to opiates.

How Does Buprenorphine Work?

People who have become addicted to or dependant upon opiates grow extra opiate receptors in the brain. Naturally occurring levels of opiates in the brain can't activate these extra opiate receptors, and when these receptors go unfilled, withdrawal symptoms occur. Once people become opiate dependent, they need a constant intake of opiate drugs just to keep withdrawal symptoms away.

Buprenorphine is an opiate and it can fill the brain's opiate receptors. When given in sufficient doses, buprenorphine can fill enough of these receptors to completely eliminate withdrawal sensations.

Buprenorphine is not an opiate like heroin, however. Heroin is a full agonist, which means it can activate each opiate receptor fully. Buprenorphine is a partial agonist, which means that although it can activate every opiate receptor in the brain, it can only activate each one a little bit.

What this means is that buprenorphine can activate the receptors enough to take away withdrawal symptoms and drug cravings, but it can't activate them enough to create euphoria (an opiate high).

Someone taking Buprenorphine for an opiate addiction will feel no withdrawal symptoms and no cravings to use opiates. And since buprenorphine so effectively fills opiate receptors, attempting to take another opiate (such as heroin) while on buprenorphine will have no effect.

Is Buprenorphine Safe?

Buprenorphine is safer than methadone.

As a partial opiate agonist, buprenorphine can only partially activate the brain's opiate receptors (the greater the activation of these receptors, the greater the respiratory depressive effect). People taking a very high dose of methadone or other full agonist opiates, such as heroin, risk respiratory depression and death -- but since buprenorphine can't fully activate the receptors it can't cause as strong a respiratory depressive effect.

While methadone has a narrow safe dosage window, it is much harder to overdose on buprenorphine than it is to overdose on methadone.

What Are the Side Effects of Buprenorphine?

Most people tolerate buprenorphine quite well, though the medication does have some side effects. Some possible side effects include the following:

  • Headaches
  • Nausea
  • Constipation
  • Sexual dysfunction
  • Sweating
  • Stomach pain

Why Can I Take Buprenorphine Home, Unlike Methadone?

In America, buprenorphine is commonly prescribed as the drug Suboxone. Suboxone contains two active ingredients: buprenorphine and naloxone. Naloxone stops people from injecting the medication to get high.

Suboxone can be prescribed in take home-doses because the risks of abuse and diversion are significantly lower than they are with methadone.

Who Can't Use Buprenorphine?

Buprenorphine isn't right for everyone. People with very high opiate tolerances may find that the medication, as only a partial agonist, offers insufficient withdrawal symptoms relief. Luckily, methadone will work for anyone, regardless of past opiate use.

Other reasons for buprenorphine incompatibility include the following:

  • The abuse of or addiction to alcohol or benzodiazepines
  • An inability to comply with take-home opiate medication regulations
  • Serious mental health problems
  • Pregnancy
  • Past unsuccessful use of buprenorphine for addiction
  • Low motivation      
  • Certain physical illnesses

How Long Does Buprenorphine Treatment Take?

Treatment lengths vary greatly depending on the needs and wishes of the patient. Treatment can be as short as a few days, or can be extended indefinitely

Buprenorphine is most commonly used in one of two ways:

  1. As a part of a brief detoxification protocol, reducing the severity of withdrawal symptoms from full agonist opiates.
  1. In a longer term opiate replacement maintenance program

People who take buprenorphine for longer periods of time have better results.

Where Can I Find Buprenorphine?

Only certain doctors are able to prescribe Buprenorphine. Ask your health care provider for a referral to a doctor who is able to prescribe this medication, or call the National Resource Center at 888-471-0430 to learn more about treatment options near you.

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