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- A New Option for Medication-Assisted Treatment of Opioid Dependence
- Now available from any qualified physician in the United States
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- Buprenorphine (pronounced bu-pren-OR-feen) is a new drug that has been
approved to help treat addictions to opioids such as heroin, morphine,
and Percodan. Unlike other
medically-assisted treatments, you may receive buprenorphine in a
doctor’s office.
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- Opioids are drugs that have effects like those produced by
morphine. Some opioids—like
heroin—come from the poppy plant.
Others—like Percodan, methadone and Demerol—are made from
chemicals.
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- Buprenorphine is a medicine that was originally approved for use as a
pain killer. However,
buprenorphine is now being used to treat addiction to opioids such as
heroin. The buprenorphine
combination contains buprenorphine and naloxone (there are several
product tradenames for this combination). Naloxone is a medicine that blocks the
effects of morphine, heroin, and other opioids. (Naloxone information comes in part
from NIDA Research Report Series/Heroin:
Abuse and Addiction)
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- Under a doctor’s care, buprenorphine and the buprenorphine combination
(there are several product tradenames for this combination) may be used
for withdrawal from heroin, methadone, and other opioids. Buprenorphine may also be used as a
maintenance medication that will eliminate the craving for illegal
drugs.
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- Buprenorphine is a pill that is dissolved under the tongue.
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- The correct doses of methadone allows you to carry on normal activities,
such as working and driving a car.
It also eliminates the craving for illegal opioids. If you receive methadone for
treatment, you need to take the medicine once a day. At first, you will need to go every
day to the methadone clinic to get your medicine. Before long you will be allowed to
take medication home with you and will not be required to come everyday
to the clinic. You cannot get methadone at your doctor’s office. Methadone is medically safe even if
you continue to take it for a long period of time. Some patients have been on methadone
treatment for more than 10 years.
Patients who take methadone and receive counseling or other
support services have been able to stop using heroin and other opioids
and have returned to leading normal lives.
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- Studies indicate that treatment using methadone work best with people
who have been addicted to opioids for a year or more.
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- Naltrexone is used sometimes to treat people addicted to opioids, but
only after they have been detoxified.
It can be very dangerous to take naltrexone if you are already
receiving methadone and have not been withdrawn. If you have medical problems, this
situation could be life threatening.
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- If you are interested in medically-assisted treatment—with methadone,
naltrexone, or buprenorphine -
talk with an addiction medicine specialist.
- He or she will be able to help
you decide which medicine may be best for you.
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- First, you will be able to go to a doctor’s office to receive
treatment. This means that
receiving treatment is easier and more private than it would be if you
had to go to a clinic designed specifically for the treatment of opioid
addictions
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- Fewer harmful affects with buprenorphine than with heroin and morphine
- Reduced physical dependency with buprenorphine than with methadone, for
instance.
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- Also, if you stop taking buprenorphine, your withdrawal symptoms will be
fewer and less severe than they would be if you stopped taking
methadone.
- And, if you overdose on buprenorphine—on purpose or by accident—you will
experience a higher level of safety than you would if you overdosed on
methadone.
- But remember, there may be harmful effects with any medicine that you
take.
- (Clinical Guidelines, NIDA
Research Report/Heroin: Abuse and
Addiction)
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- Family members and friends may notice that you’re more like the person
they remember—the person who wasn’t using drugs. Again, if taking the proper dosage,
you will not have the craving for the opioids, but you will also not
have the high.
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- In order to be a candidate for
buprenorphine treatment, you should:
- Want to stop using opioids
- Agree to follow the safety precautions for buprenorphine treatment
- Understand the benefits and risks of treatment
- Understand all your treatment options before agreeing to buprenorphine
treatment
- (Physicians’ Guidelines)
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- If you experience seizures, you should not use buprenorphine for
treatment. Your doctor may
discuss with you other reasons why buprenorphine would not be a good
treatment choice for you.
- (Physicians’ Guidelines).
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- Side effect may include nausea, vomiting, and constipation. However, these side effects may be
less intense than those experienced by individuals taking methadone.
- (Clinical Guidelines)
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- Buprenorphine is a safe and effective medicine for treatment as long as
you are a good candidate for this type of treatment AND you follow your
doctor’s directions. Recent tests
indicate that buprenorphine is just as effective as are moderate doses
of methadone.
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- The possibility of abuse of buprenorphine is less than it is for other
opioids. In part, this is due to
the fact that buprenorphine has what is called a “ceiling effect.” This means that at a certain point,
the effect of buprenorphine does not increase when you increase the
dosage. (Physicians’ Guidelines,
p. 11)
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- Because of the way buprenorphine acts on the body, it is difficult to
overdose on it. However, if you
are taking other medicines, or illegal drugs, high doses of
buprenorphine may cause serious illness or death.
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- Be sure to tell your doctor about any other prescribed medicines you are
taking—like medicine to treat depression, anxiety, or problems with
sleeping. This information will
help the doctor make good decisions about your treatment. Also tell your doctor about any or
over-the-counter medicines that you are taking AND about your alcohol
use. Remember: If you don’t tell the doctor about all
the medicines you take and about your alcohol use, you might end up with
some serious health problems. (Physicians’
Guidelines, p. 13)
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- It will take some time to determine the dosage that will work best for
you. While daily doses will be
necessary in the beginning and until you are stabilized, most patients
will stabilize on doses of 32 mg a day or less. It may be possible to take doses every
other day, since buprenorphine’s effect lasts longer than methadone.
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- Buprenorphine has been used for both long-term maintenance and for
medically supervised withdrawal.
However, as is true with any medicine, it is very important that
you discuss with your doctor the use of buprenorphine to help you
withdraw from heroin or methadone.
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- You may become physically dependent on buprenorphine if you take it for
the treatment of opioid addiction.
However, your physical dependence on buprenorphine is less than
it would be with other medicines and drugs such as methadone or
heroin. A low level of physical
dependence with buprenorphine means that your withdrawal from
buprenorphine may be less uncomfortable and your withdrawal symptoms may
develop more slowly than with methadone or heroin (Physicians’
Guidelines, p.12)
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- As long as you and your doctor believe it is medically appropriate for
you to continue taking this medicine.
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- “Medication-assisted treatment is covered by some insurance
providers. Check with your
provider.”
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- Research shows that medication-assisted treatment for addiction is more
successful when people also receive other services, such as
counseling. Talk to your doctor
about referrals to services that will help you with your recovery.
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- The first step is to talk to your doctor. If your doctor has not received the
training necessary to treat you with buprenorphine, ask your doctor to
contact CSAT to find out how to obtain this training. Or you can look for a doctor in your
area by clicking on the following link:
- http://www.findtreatment.samhsa.gov/facilitylocatordoc.htm
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- We encourage you to learn about buprenorphine treatment for opioid
addiction. This new treatment
approach may be just what you need to help you become drug free. Talk it over with your doctor, and
remember—you now have another medicine that can help you recover. Find out if this is a good treatment
option for you! A wonderful resource is the National Alliance of
Advocates for Buprenorphine Treatment.
- Visit NAABT
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Notes
