As with all medications used in MAT, buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach. All the medication alternatives can be confusing at times. Spectrum Healthcare has doctors that will help you navigate the world of medications and treatments to help you beat your addiction(s).
For opioid use disorder, Buprenorphine is typically started when withdrawal symptoms have begun and for the first two days of treatment under direct observation of a healthcare provider. In the United States, the combination formulation of buprenorphine/naloxone (Suboxone) is usually prescribed to discourage misuse by injection.
How Buprenorphine Works
Buprenorphine is an opioid partial agonist. It helps stop withdrawal symptoms and satisfies opioid cravings.
When taken as prescribed, buprenorphine is safe and effective.
Buprenorphine has unique pharmacological properties that help:
Diminish the effects of physical dependency on opioids, such as withdrawal symptoms and cravings
Increase safety in cases of overdose
Lower the potential for misuse
The following buprenorphine products are FDA approved for the treatment of OUD:
Generic Buprenorphine/naloxone sublingual tablets
Buprenorphine sublingual tablets (Subutex)
Buprenorphine/naloxone sublingual films (Suboxone)
Buprenorphine/naloxone) sublingual tablets (Zubsolv)
Buprenorphine/naloxone buccal film (Bunavail)
Buprenorphine implants (Probuphine)
Buprenorphine extended-release injection (Sublocade)
Buprenorphine for Opioid Use Disorder (OUD)
To begin treatment, an OUD patient must abstain from using opioids for at least 12 to 24 hours and be in the early stages of opioid withdrawal. Patents with opioids in their bloodstream or who are not in the early stages of withdrawal may experience acute withdrawal if they start Buprenorphine too early.
After a patient has discontinued or greatly reduced their opioid use, no longer has cravings, and is experiencing few, if any, side effects, if needed, the dose of buprenorphine may be adjusted. Due to the long-acting agent of buprenorphine, once patients are stabilized, it may be possible to switch from twice-a-day dosing to once-a-day dosing depending on your doctor's advice.
The length of time a patient receives buprenorphine is tailored to meet the needs of each patient, and in some cases, treatment can be indefinite. To prevent possible relapse, individuals can engage in ongoing treatment such as counseling and meetings—with or without MAT.
Buprenorphine was the first medication to treat OUD that can be prescribed or dispensed in physician's offices.
Buprenorphine should be prescribed as part of a comprehensive treatment plan that includes counseling and other behavioral therapies to provide patients with a whole-person approach.
Buprenorphine offers several benefits to those with OUD and to others for whom treatment in a methadone clinic is not appropriate or is less convenient.
What is the typical dose of buprenorphine and how is it taken?
Every person is different, and dosing should be individualized to each person based on their report of a reduction of withdrawal symptoms and cravings.
• Most people start buprenorphine at a dose of 2-4mg and slowly increase until withdrawal symptoms stop.
• The recommended therapeutic (effective) dose of buprenorphine is between 16 mg and 24 mg.
• A typical maximum dose is 24 mg/per day, though some patients may require more to manage their withdrawal symptoms.
• Buprenorphine/naloxone (Suboxone) comes in two different forms:
o Film (buccal): Placed in cheek to dissolve
o Tablet (sublingual): Placed under the tongue to dissolve
• Other forms of buprenorphine medication include:
o Implant: Brand name Probuphine. Probuphine includes 4 implants that are placed in the arm and provide a steady release of buprenorphine for up to 6 months.
o Injection: Brand name Sublocade. Extended-release injection that lasts one month.
A person has to have had an effective dose of either the film or tablet for at least 7 days prior to getting an injection.