Buprenorphine for Pain: Is it Just for Pain Relief?

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Chronic pain is a significant problem in the United States. An estimated 100 million Americans suffer from this condition, defined as pain lasting more than three months. Several reasons contribute to the high prevalence of chronic pain, including an aging population, more sedentary lifestyles, and increased obesity.

The burden of acute pain is alarming. It results in approximately $560-$635 billion in direct medical costs annually in the United States. This cost is similar to that of heart disease, cancer and diabetes combined.

And although there are other ways to manage pain, medication is still the most common approach. About 58 percent of people with chronic pain take some form of medication. Among the types of medication commonly used for treating chronic pain is Buprenorphine. 

What is Buprenorphine and How Does it Work?

Buprenorphine is a medication that belongs to a class of drugs called opioids. An opioid medication is a pain reliever that binds to opioid receptors in the brain and spinal cord. This interaction helps to decrease the perception of pain.

Buprenorphine is unique among opioids because it is a partial agonist at the mu-opioid receptor. It means that the medicine activates the receptor, but to a lesser degree than other opioids, such as morphine. Buprenorphine also has a very high binding affinity for mu-opioid receptors, which means it stays attached to the receptor for longer. Thus, buprenorphine can treat pain for a more extended period.

However, buprenorphine contains buprenorphine hydrochloride, a schedule III controlled substance that is only available through a prescription from a healthcare provider. So if you’re considering this medication for the treatment of chronic pain, you’ll need to talk to your doctor first.

Why Do Doctors Prescribe Buprenorphine for Chronic Pain?

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Buprenorphine is a medication that is ideal for the treatment of moderate to severe pain. It is typically prescribed when other pain medications, such as acetaminophen or ibuprofen, are not working.

Buprenorphine is also an attractive option for chronic pain patients because it has a lower risk of addiction and abuse than other opioid analgesics. Clinical pharmacology of buprenorphine has found the drug to have a ceiling effect, which means that there is a limit to the amount of pain support that can be achieved with increasing doses. This ceiling effect reduces the potential for substance abuse and overdose.

In addition, the analgesic effect for patients treated with Buprenorphine is comparable to that of other medications, making it an excellent choice for patients with chronic pain.

What is Belbuca?

Belbuca is a brand-name prescription medication that contains the active ingredient buprenorphine. Although the two drugs are identical and have the same therapeutic effects, many patients prefer this brand for chronic pain management because it is readily available in a sublingual film form, which is easy to use.

Nonetheless, both medications can be effective in providing adequate pain relief for pain severe enough to require an opioid analgesic.

Is Buprenorphine Similar to Suboxone?

Buprenorphine is sometimes confused with Suboxone because they are both partial μ opioid receptor agonists. However, there are some critical differences between these two medications.

Suboxone is a combination of buprenorphine and Naloxone, while Buprenorphine is just Buprenorphine hydrochloride. Naloxone is added to Suboxone to discourage misuse and abuse because it can cause unpleasant withdrawal symptoms if the medication is injected.

Buprenorphine, on the other hand, does not have this addition, making it more attractive to patients struggling with addiction. It should be noted that Buprenorphine can still be abused, and patients should take the medication only as prescribed by their healthcare provider.

How to Use Buprenorphine for Chronic Pain Management

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Buprenorphine is available in multiple formulations, including sublingual tablets, films and implants. Depending on the severity of the pain and the patient’s individual needs, the healthcare provider will determine which formulation is best.

For most patients, sublingual Buprenorphine tablets or films are a good option. These formulations are designed to dissolve under the tongue, so they can be taken without water. The same goes for Buprenorphine buccal film, which is placed between the gum and cheek.

On the other hand, a transdermal buprenorphine patch may be a better choice for patients with difficulty swallowing pills. The patch is applied to the skin and provides a steady release of the medication for 72 hours.

But if the patient is experiencing pain severe enough to tolerate, an intravenous Buprenorphine might be necessary. This formulation is given as a shot and can provide quick pain suppression.

No matter which formulation is chosen, it’s crucial to follow the directions on the prescription label and take Buprenorphine precisely as prescribed. The medication should be taken at the same time each day to maintain a consistent level of the drug in the body.

What Special Precautions Should I Follow?

A healthcare provider must closely monitor patients receiving buprenorphine to ensure that the drug is working correctly and that there are no adverse effects.

Below precautions are important to keep in mind:

Drug Interaction

Buprenorphine can interact with other medications, so it’s essential to tell the healthcare provider about all the drugs being taken, including over-the-counter medications, vitamins and herbal supplements.

Alcohol Use

Patients should also avoid alcohol use while taking Buprenorphine as it can increase the risk of overdose and death. Alcohol depresses the central nervous system, and when combined with Buprenorphine, it can amplify these effects.

Driving and Operating Machinery

Buprenorphine can cause drowsiness, so it’s essential not to drive or operate machinery until the effects of the medication are known.

Heath Conditions

Several health conditions can affect how Buprenorphine works in the body. Be sure to tell the healthcare provider about any history of liver or kidney disease, mental illness, seizures, or head injury.

Pregnancy and Breastfeeding

Buprenorphine should be used with caution in pregnant women as it can cause life-threatening withdrawal symptoms in newborns. Unlike opioid withdrawal syndrome in adults, neonatal opioid withdrawal syndrome (NOWS) can be fatal. Therefore, it’s essential to tell the healthcare provider if pregnancy is a possibility.

It’s also important to know that Buprenorphine passes into breast milk and can cause serious side effects in nursing infants. So, mothers who are breastfeeding should not take this medication.

What are the Side Effects of Buprenorphine?

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As with any medication, there are potential side effects associated with Buprenorphine. However, it’s important to note that not all patients will experience side effects. Some may only get a few, whereas others may not experience any at all.

If side effects do occur, they are usually mild and resolve on their own with time. But in some cases, they can be more severe and require medical attention.

Here are some of the most common ones you should be aware of.

Respiratory Depression

Buprenorphine-induced respiratory depression is a potentially life-threatening side effect. It occurs when the drug slows down the respiratory system to the point where not enough oxygen gets to the brain. Symptoms include slow or shallow breathing, feeling drowsy or dizzy, and confusion. If you experience any of these symptoms, seek medical help immediately.

Withdrawal Symptoms

Long-term opioid treatment can lead to tolerance, dependence and addiction. So when Buprenorphine is abruptly stopped, it can cause opioid withdrawal syndrome. This condition is characterized by agitation, anxiety, muscle aches, sweating, and a runny nose. These effects are usually mild and resolve within a few days. The use of opioid antagonists can also precipitate withdrawal. That’s why it’s important to taper off Buprenorphine slowly under the supervision of a healthcare provider.

Opioid Addiction

Opioid dependence is the most common side effect of Buprenorphine. It occurs when the patient develops a tolerance to the drug and needs to take increasing amounts to get the same effect. To prevent this from happening, your doctor should regularly provide an opioid analgesic risk evaluation to identify if opioid analgesics outweigh the risks of overuse.

What to Do With Buprenorphine Overdose

Opioid overdose can happen when too much of the drug is taken or when it’s taken with other substances. It can lead to life-threatening respiratory depression and even death.

But this condition can be prevented with the following steps:

Appropriate Buprenorphine Therapy

Physical dependence can happen with opioid abuse. To avoid this, healthcare providers must be careful in prescribing Buprenorphine, and pharmaceutical establishments should be careful in dispensing prescription drugs.

Intensive Counseling

Opioid use disorder can lead to psychiatric disorders. Such patients receiving improper treatment of opioid drugs can lead to drug misuse. Belbuca exposes patients to opioid-induced hyperalgesia, causing the central nervous system to experience adverse reactions. But with intensive counseling, patients will be more likely to follow their treatment plan and avoid drug misuse.

Injection of Naloxone

This rescue medication is helpful in treating an opioid overdose in an emergency situation. It can be injected into a muscle or vein, and it works by quickly reversing the effects of the opioid.

Patients with a known or suspected overdose should be promptly treated with naloxone.

If you or someone you know is struggling with an addiction to opioids, please seek help from a healthcare provider. There are many resources available to get you the treatment you need.

Chronic opioid therapy with buprenophrine is one of the most reliable and evidence-based methods for treating pain. With their well-known efficacy, patients should understand all there is to know about their side effects. Learning about the risks and how to prevent them can help patients stay on track with their treatment plans and improve their quality of life.

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