Buprenorphine is a powerful painkiller used to treat chronic pain and opioid addiction.
Today I’ll answer some common questions that people ask me about buprenorphine
What is buprenorphine? Is it an opioid?
Why is buprenorphine combined with naloxone?
Why is it used for opioid addiction? What is the dose of buprenorphine for pain?
Can I swallow the tablet instead of dissolving under the tongue?
Can I take it with other opioids? Why do I need to stop the other
opioid before starting buprenorphine? So, let’s talk about buprenorphine today
Buprenorphine is a long-acting strong opioid. The effects last about 24 to 36 hours. It is
used as a opioid painkiller and also to replace other opioids that people may get addicted to,
like heroin, oxycodone, fentanyl or morphine. For pain, it is used as a transdermal patch. There
are patches containing 5, 10 and 20 micrograms per hour. The maximum dose is 20 micrograms per hour.
For opioid addiction, there is the sublingual tablets that combine buprenorphine with naloxone,
and there are also injectable buprenorphine that are used once a month.
The sublingual tablet has to be dissolved under the tongue, if the person swallows the
tablet the drug will not be absorbed and therefore cannot have an effect.
Naloxone is added to the tablet to avoid that the person will dissolve the table and injecting
the drug to get high. Buprenorphine is used
to treat opioid addiction because it prevents withdrawal symptoms and reduces cravings. So,
the person does not need to obtain illegal opioids to feel normal, and they have an
opportunity to rebuild their lives. Buprenorphine can be abused and it
can cause overdose, but these are rare and much less than using methadone.
When we want to rotate from another opioid to buprenorphine, we use a method called induction.
Because buprenorphine has a high affinity to the opioid receptor, this means that when it
links to the receptor in the body, it does not let another opioid to connect to that receptor.
It stays there for 24 or 36 hours. If you take another opioid with buprenorphine,
the opioid will not find an empty receptor and will not be able to have the analgesic effect.
So, if the person is taking another opioid, let’s say, morphine or oxycodone,
we first need to empty those receptor, and that is why we need to ask the person to stop
taking all of their opioids before we given them the first dose of buprenorphine. When
they come to our office, the person will have some withdrawal symptoms, then we give them
the first sublingual tablet of buprenorphine, and they feel better in a few minutes. Then,
we adjust the dose of buprenorphine and within a few days they are taking the buprenorphine only.
Why do we want to do this? Buprenorphine is safer than other opioids. It is a partial
agonist to the receptor, which means that there is a lower chance of overdose by respiratory
depression. It is safer in older adults. If a person is using buprenorphine,
they still can take the other opioids if there is an emergency and they have acute pain, but they
should not use the other opioid for a prologued time, just for a few days in case of emergencies.
Let me remind you that this video is not intended to replace medical advice. If you have a condition
that needs medical advice, please talk to your doctor. This video is for educational purposes
only. If there is an emergency, please go to the nearest emergency department or call an ambulance.
Thank you for watching Goodbye