Used properly, and under medical supervision, buprenorphine can be a valuable part of a treatment plan for addiction or chronic pain. But despite these important medical uses, buprenorphine may be abused in a manner which leads to dependence, addiction, withdrawal, and, for some, overdose.
With the right combination of treatments offered through a comprehensive drug rehabilitation program, sobriety and a healthier life is possible.
What Is Buprenorphine?
When used as part of medication-assisted therapies for opioid use disorders (OUD), buprenorphine reduces or alleviates symptoms of withdrawal or serves as a maintenance medication to prevent continued opioid abuse.
In addition to being a medication used to treat opioid use disorders, buprenorphine has a lesser known use: as a medication to treat severe pain. Any medications used for either of these purposes can be abused, though the medications used to treat withdrawal and addiction are more commonly diverted for this purpose.
When used to treat severe pain, buprenorphine is administered as a buccal film called Belbuca or as Butrans, a transdermal patch. A buccal film is placed inside the cheek where the medication dissolves and is absorbed into a person’s system, whereas a transdermal patch is placed on the skin.
As a treatment for an OUD, buprenorphine is offered in three forms, all of which contain naloxone in addition to buprenorphine. Each of these medications is delivered into the body differently:
- Bunavail, as a buccal film
- Suboxone, as a sublingual film
- Zubsolv, as sublingual tablet
Sublingual means that the medication is placed under the tongue so that it can be quickly absorbed into the blood.
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Buprenorphine is an opioid partial agonist, which means the hallmark opioid effects of respiratory depression and euphoria, while present, are less than they would be with full opioids, like heroin. While this characteristic is meant to reduce abuse, some individuals still abuse buprenorphine for these effects.
Naloxone is a a pure opioid antagonist which is added to buprenorphine to discourage abuse further. In situations of abuse, naloxone can cause a person to experience withdrawal, though many individuals persist at abuse despite this.
When abuse occurs, individuals may use these medications in greater than prescribed quantities, or they may alter the form of the medications. Some individuals crush sublingual tablets so they can inject or snort the drug, while others dissolve the strips into water for the purpose of injection.
Signs And Symptoms Of Buprenorphine Abuse
Tolerance, dependency, and withdrawal, when accompanied by other physical and behavioral signs of addiction, are three major physical cues of buprenorphine abuse and addiction.
When a person becomes tolerant, the dosages of buprenorphine they’re using begin to climb. This is because the amounts they once used no longer create the feel-good or pain-relieving effects they seek. Raising dosages is an attempt to override this state, an action which increases the extent of physical dependency, intensity of withdrawal and risks inherent to abuse.
A physical dependency means that a person’s body has become accustomed to the steady flow of the drug and now relies on it to function. In this state, should a person quit or reduce the amounts of the drug, they will likely become sick and go into withdrawal. If a person experiences withdrawal symptoms along with other behavioral signs of addiction, there is cause for concern.
While it’s true prescribed, medical use can cause these physical shifts, an addicted state is defined by other changes within a person’s life, most notably to their day-to-day routines, behaviors and by their increasing inability to take care of their fundamental needs.
Behavioral signs of buprenorphine abuse include a person:
- finding that they are unable to quit or reduce their dosage should they try to do so.
- becoming very upset if they run out of the drug.
- hoarding or stealing pills.
- purchasing pills off the street and/or offering to buy them from loved ones.
- “doctor shopping,” or going to multiple doctors to obtain numerous prescriptions for the drug.
- struggling financially due to the amounts of money invested in chronic drug use.
- pushing loved ones away and having new “friendships” (people they use drugs with).
- losing interest in once-enjoyable activities or hobbies.
- using drugs even when it’s causing them to struggle within their relationships, job or schooling.
- continuing abuse even though their mental and physical health is declining.
When an individual is abusing buprenorphine, their body and brain will experience certain side effects which point towards abuse, including:
- dry mouth
- flushed skin
- mood instability
- pain suppression
- slowed breathing
To overcome the weakened euphoric effects of buprenorphine, individuals often increase dosages, an action which also increases respiratory depression and other potentially dangerous side effects.
Dangers Of Buprenorphine Abuse
One of the biggest dangers of buprenorphine abuse is addiction, a risk which some overlook due to this medication’s use as a treatment for addiction and pain. Addiction can consume a person to the extent that their quality of life rapidly deteriorates under the constant pursuit and use of the drug.
When drug abuse rules a person’s thoughts and motives, that person may no longer put effort into the upkeep of their health, relationships, careers or schooling, behaviors which can result in sickness, divorce, loss of a job or dropping out of school.
The loneliness and isolation which often occurs during addiction can bring about or aggravate depression and anxiety. In fact, opioid abuse has been found to cause depression in some individuals, a mental health disorder which can endanger a person’s health, well-being and life if left untreated.
If buprenorphine is injected, a person may acquire a transmissible disease like HIV/AIDs or hepatitis B or C. Collapsed veins, cellulitis, track marks and abscesses are all complications which could accompany this dangerous method of use. Altering the means of administration can also raise the risk of overdose.
Overdose From Buprenorphine Abuse
An overdose from buprenorphine occurs as a person’s central nervous system begins to shut down. The falling breathing, heart, blood pressure and temperature rates which result can lead to severe respiratory depression, coma or death.
Recognizing the signs of overdose can help to prevent one from progressing to these extremes. As outlined by MedlinePlus, signs may include:
- blurred vision
- cold, clammy skin
- pinpoint pupils
- slowed breathing
- unusual snoring
- weakened muscles
Buprenorphine has a ceiling effect, which means the opioid effects become less predominant as use continues. To overcome this or a tolerance, an individual may increase their dosage, thereby increasing the potential for overdose.
If you suspect that a loved one is overdosing, contact emergency medical services immediately.
According to the DailyMed, buprenorphine “withdrawal syndrome is typically milder than seen with full agonists and may be delayed in onset.”
When withdrawal occurs, a person may experience physical and mental discomfort, the symptoms of which may include:
- body aches
- dilated pupils
- runny nose
- teary eyes
Withdrawal symptoms vary and are dependent on the severity and frequency of abuse, among other factors unique to each person.
Medically-Supervised Buprenorphine Detoxification
Opioid addictions often require a two-pronged approach to treatment. With the potential for intense physical dependencies and withdrawal, many people may require a medically-supervised detox before proceeding to rehabilitation.
During detoxification, certain medications may be used to reduce the symptoms of withdrawal. The exact medications used depend on the person, their health and the severity of abuse.
Once a person’s body has stabilized, and the drug has been sufficiently cleansed from their system, rehabilitation for the psychological addiction will take place.
Treatment For An Buprenorphine Addiction
The mental and emotional effects of addiction can run deep, factors which require time, intensive therapy and personal commitment to treat. For these reasons, inpatient drug rehabilitation programs are quite often the preferred choice of treatment for many, especially for opioid addictions.
Addiction is a disease, and like other diseases, it requires medically-sound, researched-based treatments to achieve true healing and to facilitate lasting recovery.
At Vertava Health we adhere to these beliefs. Our residential treatment programs blend evidence-based practices with other dynamic treatment methods to provide you with the best opportunity for addiction treatment.
For information on how to overcome buprenorphine addiction, contact us today.