Buprenorphine is an opioid medication primarily used to treat addiction to other, more dangerous opioids. However, buprenorphine use can still carry some risks.
Article at a Glance:
- Buprenorphine is one of two opioids approved for medication-assisted treatment (MAT) in the United States.
- Buprenorphine is a partial opioid agonist; the effects are not as strong as other opioids, but it helps prevent opioid withdrawal.
- Buprenorphine side effects are similar to those of other opioids, and the drug also has the potential for abuse and addiction.
What Is Buprenorphine?
Buprenorphine is a semi-synthetic opioid medication used for pain management as well as opioid addiction treatment. It was first developed in the 1960s, and in 2002, it was approved by the FDA for use in opioid addiction treatment. In the past decade, it has gained increasing popularity as an alternative to methadone. Buprenorphine is available in different formulations under the brand names Subutex, Suboxone, Sublocade, Buprenex and Butrans.
How Buprenorphine Works
Buprenorphine is a partial agonist of mu opioid receptors, which are involved in processing pain signals in the body. Most prescription opioids are full agonists, meaning they attach much more tightly to opioid receptors. Because buprenorphine is a partial agonist, it has a weaker effect than opioids like oxycodone, fentanyl and heroin.
When taken as prescribed, buprenorphine is a safe and effective medication for opioid use disorder. Buprenorphine has unique properties that reduce withdrawal symptoms and cravings, lower the potential for misuse and reduce overdose risks.
Using Buprenorphine for Opioid Addiction Treatment
Buprenorphine is primarily used to treat opioid use disorders. As a part of opioid replacement therapy, it can help patients manage cravings and withdrawal symptoms during drug detox and ongoing treatment.
Opioid Replacement Therapy
Also called opioid maintenance therapy, medication-assisted treatment (MAT) involves replacing more dangerous opioids like heroin or oxycodone with substitutes that last longer and produce less euphoric highs. Along with other forms of treatment, substitute opioids allow patients to manage cravings and withdrawal symptoms. Over time, patients are safely and gradually weaned off the opioid substitute.
Buprenorphine vs. Methadone
For many decades, the primary opioid replacement drug was methadone. However, studies suggest that buprenorphine is similarly effective to methadone for opioid addiction treatment. Although buprenorphine interacts with some opioid receptors in the brain, it blocks others. This prevents other, more dangerous opioids from reacting with receptors if they’re taken while buprenorphine is active.
Unlike methadone, buprenorphine can be prescribed out of physician offices, making the medication more accessible. Because of its relative safety, buprenorphine has different prescription requirements than methadone. It also has a variety of formulations that methadone does not, including drug combinations like Suboxone (buprenorphine-naloxone) that reduce the risk of overdose.
Common Side Effects of Buprenorphine
Buprenorphine side effects are similar to those of other opioids. Commonly reported side effects include:
- Drowsiness or insomnia
- Loss of coordination
- Shallow breathing
- Blurred vision
- Constipation
- Headache
- Dizziness
- Memory loss or difficulty concentrating
- Dry mouth
- Sexual dysfunction
Withdrawal Syndrome
Buprenorphine is used to help mitigate withdrawal symptoms from other opioids. However, this medication can also create symptoms when someone stops taking it. Buprenorphine withdrawal symptoms may include:
- Drug cravings
- Nausea and vomiting
- Headaches
- Muscle aches
- Insomnia
- Lethargy
- Digestive distress
- Anxiety
- Depression
- Irritability
- Fever or chills
- Sweating
As with any drug treatment, it’s important to follow the guidance of a doctor or clinic to manage symptoms and ensure safety.
Buprenorphine Misuse Potential
Despite being an effective drug for people recovering from opioid addiction, buprenorphine still has the potential for abuse and addiction. As an opioid, the drug causes the release of dopamine, a chemical involved in pleasure and addiction. For this reason, it is considered a Schedule III medication by the Drug Enforcement Agency (DEA).
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Drug Enforcement Agency (DEA). “Buprenorphine.” December 2019. Accessed September 13, 2021.
National Institute on Drug Abuse. “How Do Medications to Treat Opioid Use Disorder Work?” June 2018. Accessed September 13, 2021.
Substance Abuse and Mental Health Services Administration. “Buprenorphine.” May 14, 2021. Accessed September 13, 2021.
Substance Abuse and Mental Health Services Administration. “Chapter 3B: Methadone.” 2018. Accessed September 13, 2021.
Kumar, Rachna; et al. “Buprenorphine.” StatPearls, August 6, 2021. Accessed September 13, 2021.
Shah, Mansi; et al. “Opioid Withdrawal.” StatPearls, May 21, 2021. Accessed September 13, 2021.
Indivior. “Subutex.” U.S. Food and Drug Administration, February 2018. Accessed September 13, 2021.
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