Buprenorphine is a partial opioid agonist, meaning it activates the same receptors in the brain as opioids, but to a lesser degree. This unique property makes it an effective medication for treating opioid dependence while reducing the risk of respiratory depression and overdose associated with full opioid agonists like methadone.
Buprenorphine works by attaching to the same receptors in the brain that are targeted by opioids like heroin, prescription painkillers, and methadone. The ceiling effect reduces the risk of overdose associated with methadone. Buprenorphine also has a long-lasting effect, allowing for less frequent dosing compared to methadone.
When taken as prescribed, buprenorphine can:
The U.S. Food and Drug Administration (FDA) has approved several buprenorphine products for the treatment of opioid dependence, including:
A common form of buprenorphine is a sublingual film known as Suboxone. The film works by placing it under the tongue and waiting for it to dissolve. In addition to buprenorphine, Suboxone also contains naloxone, an opioid blocker. When taken as prescribed (sublingually), naloxone remains inactive and does not affect the user. However, if someone attempts to misuse Suboxone by injecting it, naloxone will block the euphoric effects of opioids, which can precipitate withdrawal symptoms.
Zubsolv is another buprenorphine/naloxone combination product. It is also a sublingual tablet. Zubsolv is designed to dissolve more rapidly than Suboxone, potentially improving absorption and patient convenience.
Another long-term buprenorphine treatment is Probuphine, a buprenorphine implant. These implants release a steady dose of buprenorphine over several months, reducing the need for daily dosing and helping patients maintain their recovery without the hassle of daily medication. Probuphine has to be inserted under the skin by a healthcare provider.
Subutex are sublingual tablets that contain only buprenorphine. This method allows for quick absorption into the bloodstream, bringing faster relief for cravings and withdrawal symptoms from opioids. In addition to bringing faster relief, the main benefit of Subutex is that it maintains a stable level of medication in the body, which helps patients manage their addiction more effectively.
Bunavail is buccal buprenorphine film. It is placed between the gum and cheek, allowing the medication to be absorbed through the mucous membranes in the mouth. This form also includes naloxone and offers similar benefits regarding misuse prevention and managing opioid cravings.
Sublocade is an extended-release injection that provides a long-lasting form of buprenorphine. This injection can last for a month or longer, making it an excellent option for patients who prefer not to take daily medication. The benefit of this form is that it ensures consistent medication levels in the body, which can help stabilize patients in their recovery journey. The injection must be administered by a healthcare provider.
Methadone and buprenorphine are widely used as part of MAT for opioid addiction treatment, and have proven effective when introduced as part of a comprehensive care plan for individuals in recovery. However, the way each medication works and how it is administered play a big role in how people react to treatment.
In general, methadone is valued for its reliability and social support system, and buprenorphine is coveted for its flexibility, low overdose risk and milder withdrawal symptoms.
For decades, methadone has been the gold standard for treating opioid dependence. When taken as prescribed, methadone helps alleviate withdrawal symptoms and cravings associated with opioid addiction.
Methadone is a synthetic opioid used primarily for pain management and as part of a treatment program for opioid use disorder. Methadone is provided at clinics, requiring daily appointments during the first months of treatment. Methadone clinics offer a structured environment for individuals seeking recovery, as they provide counseling and support groups on top of regular dosing.
However, the in-person nature of methadone treatment and the clinic’s schedule can be inconvenient, especially when it clashes with work schedules and family life. People living outside of urban areas might also struggle to commit to and from the clinic.
Because methadone is still an opioid medication, it can be abused or lead to addiction if not taken as prescribed. Methadone withdrawal can also be harder and longer than withdrawal from other opioids. These medicinal and logistical challenges of methadone represent a drawback that leads some individuals to search for an alternative treatment.
In recent years, buprenorphine has emerged as a viable alternative to methadone for the treatment of opioid dependence. One of the biggest advantages of buprenorphine is that it can be taken at home, unlike methadone. This makes it easier for people in recovery to combine treatment with work and family schedules, and does not require visits to a clinic, which can be an issue for many because of personal or logistical challenges.
Buprenorphine also has a unique advantage over methadone, which is its “ceiling effect”. After a certain dose, taking more buprenorphine does not increase its effects. This lowers the risk of overdose and serious side effects, like respiratory depression, significantly. Buprenorphine is also associated with milder withdrawal symptoms than methadone.
Buprenorphine is an efficient medication to alleviate withdrawal symptoms and cravings. It is generally considered a more accessible, convenient and safer option for many. If you are considering switching from methadone to buprenorphine, the recovery specialists at Eleanor Health can help you figure out a treatment plan and your health insurance coverage.
At Eleanor Health, our MAT program for opioids includes different forms of buprenorphine, like Suboxone and Zubsolv. Combined with our other virtual addiction treatment services, buprenorphine represents a more flexible and convenient option for people in recovery.
