Buprenorphine is a drug used in medication-assisted treatment for opioid addiction. Leading brands include Suboxone and Zubsolv. It is largely safe, but that’s not always the case; buprenorphine-related emergency room visits increased five-fold between 2006 and 2011. Buprenorphine is not without health risks and side effects, and buprenorphine addiction is a distinct possibility.
What Was Buprenorphine Designed to Do?
Opioids such as painkillers and heroin bind to opioid receptors in the brain. They slow down breathing, alleviate pain and induce relaxation.
When an opioid and the opioid receptors are a perfect match, intense euphoria is another effect. As tolerance builds, duplicating that sense of well-being requires higher doses. You might say that opioids teach your brain to crave them.
Buprenorphine is classified as a mixed opioid agonist-antagonist. Simply put, it’s a partial opioid. It attaches to receptors as well, but the binding process is not an ideal match. Two things happen as a result.
First, the brain receptors are tricked into thinking that a full opioid has latched on. The euphoric effect that makes opioids so addictive is much weaker. However, the receptors are satisfied, so to speak, and withdrawal does not occur.
Second, since the receptors are already occupied by buprenorphine, there is no opportunity for full opioids like heroin to bind to them. The brain flips on a no-vacancy sign. Buprenorphine is long-acting, so it can bind for up to three days. Using opioids while taking it won’t do much for you, so cravings are not as intense.
Buprenorphine treatment takes place in three phases: induction, stabilization and maintenance. Its effects gradually increase until they eventually hit a ceiling and level off. The idea is to slowly, gently wean off a drug of choice like heroin.
Buprenorphine is formulated to discourage misuse and prevent dependency. In theory, cravings and other side effects of withdrawal are easier to manage so that people in rehab can focus on proven methods of treatment.
Unfortunately, not every user has that experience.
What Can Go Wrong?
Like any drug, buprenorphine can be dangerous if a patient has certain health issues or misuses the product. Substance abusers are often in poor health, and they tend to knowingly or unknowingly take drugs at the wrong doses.
Conditions that any prescribing doctor should know about include liver disease, head injury, seizures and breathing problems.
Many buprenorphine users experience side effects similar to those of opioids:
- Nausea or vomiting
- Difficulty sleeping
- Muscle aches and cramps
What Is the Likelihood of Becoming Addicted to Buprenorphine?
It is telling that drug dealers sell Suboxone on the street. If it weren’t addictive, that would hardly make good business sense.
Because buprenorphine acts somewhat like an opioid, many doctors view taking it as more or less swapping one bad habit for another. Remember that buprenorphine is just a watered-down version of more powerful drugs. People who miss the intense high of opioid use may be tempted to up the dose.
Some users who didn’t have an opioid addiction to begin with use it recreationally. They are at equal risk of becoming addicted.
Naloxone, a drug designed to reverse opioid overdose, is added to buprenorphine to block opioid withdrawal. Taken in tablet form, the combination drug is generally safe. However, many recreational users crush the pills and either snort or inject them, which causes the naloxone effect to dominate. There is a brief high before severe withdrawal symptoms and cravings set in. Drug-seeking behavior and addiction are likely outcomes.
It’s worth noting that needle use comes with a high risk of contracting hepatitis. Since buprenorphine isn’t exactly liver-friendly to start with, injecting it is a recipe for disaster. Dark urine, loss of appetite, yellow eyes and skin tone, severe stomach pain and persistent nausea are all signs of liver damage that warrant a visit to the doctor.
Buprenorphine is even more dangerous if it’s used in combination with other drugs that slow down breathing. Mixing it with alcohol, tranquilizers, sleeping pills or marijuana increases risk for all addictions. Respiratory failure or fatal overdose are also possible.
Impaired coordination, brain fog, slurred speech and itching are telltale signs of buprenorphine addiction. You may also be on shaky ground if you show any of these behaviors:
- Taking more than the prescribed dose
- Continuing to use buprenorphine even when there are negative consequences
- Lying about how much you use
- Attempting to get prescriptions from more than one doctor
Is There a Better Way?
Addiction is a complex brain disease. In addition to the chemical changes that take place, there are strong psychological associations with drug use.
The best treatment programs are comprehensive. They are tailor-made to address individual needs and allow for flexibility. They tackle coexisting problems like depression and anxiety. They explore the underlying reasons, such as stress, loneliness or sexual abuse, for drug-seeking behavior.
Well-rounded treatment provides individual therapy, group counseling and self-help methods in an emotionally supportive environment. People who choose to stay in recovery long term have a much greater chance of staying clean for life.
Reach Out Now
Buprenorphine may help certain people, but no drug covers all the bases like a quality rehab program. If you fear that you may be spiraling into addiction, don’t wait another day to seek help. Call Ocean Hills Recovery to speak to a caring counselor and start your journey to recovery.
About the author:
Nicole earned her doctoral degree in Psychology with an emphasis on marriage and family therapy at California School of Professional Psychology. Her doctoral thesis was a grounded theory study exploring the role of alienation and connectedness in the life course of addiction. She specializes in treating addiction and trauma. She is certified in DBT and EMDR, two of the most highly regarded evidence-based methods in psychotherapy. Dr. Doss is a strong LGBT advocate and provides open and affirming support to her LGBT clients.
Dr. Doss’s earlier education included graduating cum laude from the University of California, Irvine in June of 2007 with a Bachelor’s degree in Psychology. While there, she received honors recognition by Psi Chi and Golden Key honor societies.
Nicole has been working with alcoholics and addicts in our California drug and alcohol rehab center as an advisor and counselor for many years. She is passionate about providing quality counseling and care to her clients. Her main focus is on integrating the 12 Step and disease models of addiction with experiential therapeutic theory. She is married to Greg; they have two adorable sons together and an energetic yellow Labrador Retriever.