What is Buprenorphine?

Buprenorphine is a pharmaceutical drug used in the treatment of opioid addiction and also as a pain management alternative. For addiction, buprenorphine is a partial opioid agonist and has been proven effective in reducing or eliminating the painful effects of opioid withdrawal syndrome.

In the United States, physicians can become approved to write prescriptions for buprenorphine to treat a patient’s opioid addiction. In 2016, the patient limit for each doctor was raised to 275 in order to enable physicians to help more people struggling with the debilitating effects of chronic opioid withdrawal.

Buprenorphine is safe, administered orally in most cases, and can be used on a short-term or long-term basis without negative health effects. Buprenorphine is the active ingredient in the popular drug, Suboxone, which is comprised of a combination of buprenorphine and naloxone.

There are more than 20,000 U.S. physicians currently approved to treat addiction with buprenorphine. Buprenorphine is generally provided in an office setting by prescription. This makes it tremendously convenient for individuals who are busy and expected to manage daily responsibilities.

How is Buprenorphine Taken?

Buprenorphine is typically available as a tablet or thin film formulation (like with Suboxone) that is dissolved under the tongue where it is quickly absorbed into the bloodstream. The medication is taken once daily, most often in the morning. Buprenorphine remains active in an individual’s system for 24 hours so the relief that it provides from opioid withdrawal is sustained throughout the day.

How Long Should a Person Stay on Buprenorphine?

There is no set length of time. The decision to remain on buprenorphine is best determined by the patient and their physician, and will depend on the patient’s health, goals, progress, and medical need. Some patients utilize buprenorphine therapy for only several weeks as they taper down on the medication during a planned opioid detoxification. Others may take longer to achieve a gradual outpatient detox, up to 3-6 months. Still others may elect to remain on buprenorphine for maintenance therapy (for a year or more) until they are psychologically and physically ready to come off of buprenorphine under the guidance of their physician.

What is the Best Method for Coming Off of Buprenorphine?

There are several detox protocols that center around a gradual, planned taper. Tapering is considered the best strategy. A planned taper has the patient reduce the amount of buprenorphine medication at intervals. The body may take several days or weeks to adjust to the slightly lowered amount of medication. The medication reductions are usually small enough that the patient is not stressed by them or physically compromised. Once the patient has stabilized on the lower dose, then another small reduction in dosage is pursued. This is the gradual taper process and it is much preferred over abruptly stopping buprenorphine. Abruptly discontinuing buprenorphine typically results in the sudden onset of withdrawal sickness and raises a patient’s risk of opioid relapse.

Many patients have successfully come off of buprenorphine-based medications using the gradual taper method.