Buprenorphine detoxification and medically-assisted withdrawal

What is Buprenorphine and what is it prescribed for?

The drug Buprenorphine is a narcotic painkiller (analgesic) that works in the brain and the central nervous system to decrease pain. Although it is prescribed for the treatment of moderately acute pain to moderately chronic pain in those individuals that are non-opioid tolerant, it is also used in the treatment of opioid addiction. In itself, Buprenorphine is a semi-synthetic opioid. The drug enables those individuals that have become addicted to opioids such as heroin or morphine to discontinue using them with minimal side effects.

Despite the fact that it is a semi-synthetic opioid, it is a partial “agonist” that merges with the opioid receptors of the brain, digestive tract, and spinal cord. It can generated the normal effects exhibited by a partial opioid agonist but not as great as the effects that are exhibited by a full agonist (heroin, methadone, etc.). The full agonist carries the risk of potential abuse, addiction, and characteristic side effects. However, Buprenorphine is seen to have a lower risk factor and can negate the side effects of opioid agonists.

Additionally, Buprenorphine is has been seen to reduce withdrawal symptoms in heroin or morphine addicts. Lower doses of the medication enable opioid addicts to stop misusing the drugs that they are abusing, addicted to, or dependent upon without having to endure and suffer with the withdrawal symptoms that are characteristic of opioid detox. There is typically a “ceiling” that is reached when these agonist effects peak making a Buprenorphine overdose far less likely than an overdose on an actual opioid.

Detoxification and medically-assisted withdrawal using Buprenorphine

Buprenorphine is oftentimes prescribed as an alternative to methadone for opioid abuse, addiction, and dependency since methadone is seen to have certain limitations when treating these conditions. Methadone has been classified as a controlled substance and consequently can only be used legally in addiction treatment and recovery programs where licensed medical professionals are on hand to administer the drug and monitor its effects. It can also be used in clinics, hospitals, and methadone maintenance programs.

As a replacement for methadone in cases of opioid abuse, addiction, and dependency treatment, Buprenorphine has been proven to be equally as effective. Because it is a partial agonist, it contains specific properties that inhibit or help to prevent opioid abuse. As a result it has become the preferred medication for addiction treatment during the detox stage and maintenance period of a drug rehab program.

Suboxone and Subutex detox

Buprenorphine is currently being marketed under the brand names of Suboxone and Subutex and are the only medications of their type that are FDA approved (as of October, 2002). It is prescribed for the detoxification stage and long-term therapy of opioid rehab as a methadone substitute. It is the dominant drug of choice where this is concerned and aids addicted individuals while they are undergoing a heroin, morphine, or opium addiction rehab program and experiencing the withdrawal symptoms characteristic of the detox stage.

Common and severe side effects, withdrawal symptoms

As with any other prescribed medication, Buprenorphine is not void of displaying certain side effects. The side effects that are characteristic of Buprenorphine are divided into two categories – the more common and the severe. The more common side effects include:

• constipation
• dizziness
• drowsiness
• headaches
• nausea
• sweating
• vomiting

Medical attention should be sought if you are noticing any of the severe side effects which include the following:

• anxiety, nervousness, or panic attacks
• changes in vision
• dark urine
• depression
• difficulty breathing
• erratic mood swings
• fast or irregular heartbeat
• pale stools
• pain, redness, or swelling at the site of the injection
• severe allergic reactions including hives, itching, and rashes
• shallow or slow breathing
• swelling of the face, lips, mouth, or tongue
• tightness in the chest
• unusual weakness
• yellowing of the eyes or skin

Although this is not a complete list of all the side effects to Buprenorphine that may occur, you should still contact your physician or a health care provider if you have questions or notice anything out of the ordinary. Additionally, there are certain withdrawal symptoms to be aware of. These include:

• cramps and muscle aches
• cravings
• diarrhea
• fever
• irritability
• nausea and vomiting
• restlessness or sleeplessness

Withdrawal symptoms apply to those that occur whenever an individual is undergoing the detox stage of heroin, morphine, or opium addiction treatment.

Addiction therapy with Buprenorphine

Buprenorphine addiction therapy is comprised of three stages, specifically the induction, stabilization, and maintenance phases.

1. Induction – Buprenorphine is medically administered, usually by injection, within 12 to 24 hours after the last known opioid use
2. Stabilization – the cravings for opioids have ceased, usage of the opioid has decreased significantly or stopped altogether, and side effects have decreased considerably or no longer exist
3. Maintenance – this is part of the detox stage where the individual’s usage of an opioid substance has completely stopped and the dosage of Buprenorphine has ended completely or being administered steadily

Important safety precautions

The following is a list of information regarding important safety precautions that should be considered whenever you are being treated with Buprenorphine for opioid abuse, addiction, and dependency:

• Do not drink alcohol or take other medications that may cause drowsiness when you are being administered Buprenorphine. Medications classified as hypnotics, sedatives, or tranquilizers should be avoided. Additionally, exercise, fever, and hot weather can increase these side effects or cause dizziness and fainting as well as lightheadedness.
• One of the side effects of Buprenorphine is dizziness or drowsiness (possibly both), so you shouldn’t drive, operate machinery, or engage in any activity that could be potentially harmful.
• If you are addicted to or physically dependent upon any narcotic medicines, opioids, or other potentially addictive substances, you may experience a wide range of withdrawal symptoms when taking Buprenorphine.
• If you are pregnant or planning on getting pregnant and are taking Buprenorphine, you need to discuss this with your physician. DO NOT BREAST-FEED when you are taking the drug as it will get excreted into the breast milk and negatively effect the infant.