Buprenorphine is approved to treat opioid use disorder and has shown positive outcomes and reduced overdoses. It is used to relieve the symptoms of opioid withdrawal but is more commonly combined with Naloxone for medication-assisted treatment, most widely known as Suboxone.
Buprenorphine Treatment
La Jolla Recovery believes immensely in the power of medication-assisted treatment such as buprenorphine for drug addiction and abuse.
Buprenorphine: The Opioid Agonist
Buprenorphine and Naloxone
The combination of Naloxone and Buprenorphine is intended to attend opiate abuse. Naloxone is an opioid antagonist, meaning it does not cause any opioid effects.
Buprenorphine/Naloxone typically comes in tablets the patient places on the cheek or under the tongue to dissolve.
Detoxing with Buprenorphine
Stepping Away from Stopping "Cold Turkey"
Precipitated opioid withdrawal is a condition where the patient may experience severe withdrawal symptoms when taking their first dose of Buprenorphine/Naloxone if they have other opioids still in their system. There are two reasons why this might happen.
- Buprenorphine/Naloxone has “low intrinsic activity” because it is a partial opioid agonist. This means when the molecule attaches to a receptor site in the brain, it does not activate or light up that receptor to the same extent most other opioids do, including methadone. Naloxone/buprenorphine acts like a dimmer switch when other opioids and methadone “turn the light on.” It is like a light switch.
- Buprenorphine/Naloxone is a sticky molecule (high affinity). Once attached to the receptor, it is not likely to come off. That’s why it is so long-acting.
If someone who takes Buprenorphine/Naloxone for the first time also has other opioids in their system, the Buprenorphine/Naloxone will compete with that other opioid for the receptor. It will win the battle due to its high affinity, throwing the other opioid off the receptor site and replacing it. So, what does this have to do with stopping cold turkey?
Once Buprenorphine/Naloxone is in the receptor, its lower intrinsic activity does not activate the receptor to the same extent as the opioid just kicked out. This is what causes the withdrawal. It comes on suddenly, and the acute symptoms are challenging to overcome for hours.
Treatment with Buprenorphine
The Positive Impact of Buprenorphine as MAT
The patient should show up for the first dose of Buprenorphine/Naloxone in a state of mild to moderate withdrawal to eliminate the possibility of unnecessary pain.
Patients must be in inactive withdrawal to start Suboxone treatment. Initial withdrawal symptoms generally include sweating, nausea, muscle cramps, sneezing, and yawning.
La Jolla Recovery Center staff can help determine whether you are in withdrawal. Generally, most short-acting opioids (like oxycodone, fentanyl, morphine, and heroin) result in withdrawal symptoms starting about 5 or 7 hours after consumption, but this may vary in each person. If you have used methadone or another long-acting opioid, you must wait longer to enter the withdrawal phase.
La Jolla Recovery has a culturally rich atmosphere and wants to make you feel at home, including LGBT-identifying staff and diverse backgrounds.
Buprenorphine and HIV prevention among injecting drug addicts
Change in the role of buprenorphine (and other medicines used in agonist pharmacotherapy of opioid dependence, like methadone) is generally recognized now as an effective treatment for opioid addiction.
Buprenorphine medication-assisted treatment programs give opportunities for expanded HIV prevention among injecting drug users and a platform for implementing directly observed antiretroviral therapy for people with opioid dependence who also have HIV/AIDS. It works well as a therapy for opportunistic infections such as tuberculosis in such individuals.
Sublingual tablets of buprenorphine
Given the great importance for public health of buprenorphine, sublingual tablets are of lesser interest for abuse and recreation, as they lack the physiological effect as immediate as injections have.
Large-scale psychosocially assisted pharmacological treatment programs exist for people dependent on opioids with buprenorphine. To explore this approach of exempting sublingual tablets from specific control measures to increase the ease of access for medicinal purposes.
International health organizations recommend that countries consider exempting combination sublingual tablets with buprenorphine and naloxone from specific control measures since buprenorphine is also difficult to extract from these pills.
The risk of misuse of sublingual tablets is relatively low. However, as buprenorphine was included in the list of essential drugs, its usefulness in inpatient treatment was thus confirmed and more effective than methadone.
At La Jolla Recovery, we want to provide optional medication-assisted treatment services, including buprenorphine and suboxone, to more readily attend the detox and withdrawal process of opiates such as heroin, fentanyl, and other abused prescriptions. Other optional medication-assisted treatments include Vivitrol and different, more modern approaches instead of detoxing from methadone. If concomitant opiates were done with alcohol or stimulants like cocaine, we would provide a program specific to its detoxification with clinical supervision. If mental health disorders also need attention, we provide dual-diagnosis therapy. We believe by attending the mind with evidence-based research, we can prolong sobriety and provide support in transitioning. At La Jolla Recovery buprenorphine rehab, a family system approach is more effective than treating the individual. Learn more about our family program to support medication-assisted management.
Please let us know if you are coming from out of state and require attention on intake and coordination. Whether from New York, Texas, Arizona, or Florida, we want to make San Diego your new home. Not into Twelve Steps or AA? No worries, we meet you where you are and are here to provide a tailored program for your medication-assisted treatment.
