Butorphanol (Stadol) Addiction

Butorphanol is a synthetic morphine-like pain reliever. Butorphanol is used to treat severe pain, and it’s a narcotic or opioid antagonist. Butorphanol is a generic name, and there is a brand-name version of the drug called Stadol, although the manufacturer did recently discontinue this medication. Now, butorphanol is available only in generic versions, and various laboratories including Mylan and Novex manufacture them. Butorphanol is available as a tartrate salt version, and it can be injected, taken as a tablet or used as a nasal spray. The tablet form is only currently used in veterinary medicine because it has a low level of bioavailability in humans. Butorphanol is most commonly used to manage migraines, and in this case, it’s the intranasal version that’s usually prescribed. In some cases, butorphanol may be used to manage pain during labor, and it can be used to reduce postoperative shivering. Butorphanol is more effective in women than men in terms of reducing pain.

Butorphanol is a partial agonist and antagonist. It does affect the central nervous system, as do other opioid pain relievers. Some of the side effects possible with the use of butorphanol can include dizziness, confusion and sedation. Nausea and vomiting are common side effects as well, and less commonly patients may experience an increase in sweating. People who use butorphanol may notice agitation, changes in mood, constipation, itching or loss of appetite. Uniquely, even though butorphanol can activate opioid receptors in a way that allows it to relieve pain, it can also block the effects of opioids. If someone is dependent on opioids and takes butorphanol, they may experience sudden withdrawal symptoms.

The most commonly prescribed version of butorphanol is the generic nasal spray. The nasal spray is typically used in one nostril, as directed by a physician. In some cases, if the person still has pain anywhere from 60 to 90 minutes after the first dose of butorphanol, they may do a second spray in the opposite nostril. The nasal spray is colorless and comes in a small bottle labeled with what it is, which is butorphanol tartrate. The typical dosage of the butorphanol nasal spray is 10 mg/mL. In most cases, if butorphanol is used in the injectable version, it’s done in a hospital.

Butorphanol does come with a black box warning about its potential to be addictive and to lead to the formation of dependence. The structure of butorphanol is similar to drugs like morphine, oxycodone and even heroin. Even though butorphanol is an opioid antagonist, it’s also an opioid agonist. It can have the same effects as other commonly misused opioid drugs since it does interact with the central nervous system. The black box warning that comes with butorphanol indicates that physicians should assess the patient’s risk factors for drug misuse and addiction before prescribing it. For someone who’s used butorphanol for a period of time and who stops using it suddenly, they may go through withdrawal. While the risk of misuse and addiction is possible with butorphanol, these risks are lower than with other opioid analgesics.

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