Buprenorphine: Frequently Asked Questions
What is buprenorphine?
This is a powerful analgesic of the opioid class of drugs, that also seems to reduce the craving for heroin. Unlike methadone, which is a pure "agonist" (receptor activator), buprenorphine has a mixture of agonist and antagonist (receptor blocker) activity. Thus it is difficult to increase the dose of the drug to get a better "high", since at high doses the antagonist effect apparently kicks in and reduces the rewarding effects of the drug.
Source: www.healthcoachmd.com
Buprenorphine was originally used for pain control when it was available as an injectable drug in the U.S. It has been used as a detoxification medication in Europe since the mid-1980’s where it had been available in a tablet form. It was FDA approved for prescription in the U.S. for opiate detoxification in 2002 and the tablets became available in 2003. Buprenorphine is an opiate that significantly decreases ALL withdrawal symptoms. ...
Source: www.nabumed.com
Buprenorphine can be used to treat opioid dependence, which includes prescription drugs such as Oxycontin and other various pain medications, as well as heroin. Buprenorphine is a partial opiate agonist. It blocks withdrawal and craving without producing strong euphoria and a narcotic high, which adds to its safety and applicability where self-medicating behavior or addiction is a risk. ...
Source: www.howardkornfeldmd.com
How effective is buprenorphine?
Buprenorphine has been studied extensively since 1978, when it was first proposed for the treatment of opioid dependence. A number of clinical trials have established that buprenorphine is effective for: Suppressing symptoms of opiate withdrawal Reducing cravings for opiates Reducing illicit opiate use Blocking the effects of other opiates Helping people stay in treatment
Source: www.regionalnetwork.org
What is buprenorphine (suboxone)?
Buprenorphine is a medication used in treating people with narcotic problems. For more information visit: www.kolmac.com/buprenorphine.htm or www.buprenorphine.samhsa.gov .
Source: www.kolmac.com
Is buprenorphine like methadone?
Like methadone, buprenorphine can be used for maintenance; however in my practice the goal of treatment is to become drug free. There are many patients who do well with methadone so if you’re on methadone and are doing well, it’s always your choice whether to consider a switch to a drug free approach that starts with buprenorphine. When on methadone, if one uses another opiate, they do not feel the opiate. Similarly, buprenorphine is a “forgiving” drug. ...
Source: www.nabumed.com
How long will I be taking buprenorphine?
I tailor the detoxification to your individual needs, based on drugs used and amount used, length of addiction and other bio-psychosocial factors. Time can vary from being on buprenorphine from 10 days to 3 months. Some people need longer tapers than others. It is not a race to being drug free.
Source: www.nabumed.com
Do pharmacies need waivers to dispense buprenorphine?
Physicians are required to obtain DATA 2000 waivers to prescribe and dispense buprenorphine (Subutex® and Suboxone®) for opioid addiction, but pharmacists and pharmacies are not required to have any special credentials for dispensing these medications above and beyond those for other Schedule III medications. Certain Federal laws and regulations, however, do affect pharmacy practice with regard to opioid addiction treatment prescriptions.
No.Physicians are required to obtain DATA 2000 waivers to prescribe and dispense buprenorphine (Subutex® and Suboxone®) for opioid addiction, but pharmacists and pharmacies are not required to have any special credentials for dispensing these medications above and beyond those for other Schedule III medications. Certain Federal laws and regulations, however, do affect pharmacy practice with regard to opioid addiction treatment prescriptions.
Source: buprenorphine.samhsa.gov
How Is Buprenorphine Different From Other Opioids?
Buprenorphine, a partial opioid agonist, produces limited euphoria compared with full opioid agonists, 12 while suppressing withdrawal symptoms and reducing cravings, which helps to reinforce treatment adherence. Also, respiratory depression is limited with SUBOXONE because of its characteristic "ceiling effect. " This effect provides a margin of safety when SUBOXONE is taken alone versus a full opioid agonist. ...
Source: www.suboxone.com
Can buprenorphine be used to treat cocaine addiction?
Cocaine is not an opioid drug. According to the approved product labeling, Suboxone® and Subutex® are indicated for the treatment of opioid addiction. In addition, under DATA 2000, codified at 21 U.S.C. 823(g), prescription use of Suboxone® and Subutex® in the treatment of opioid addiction is limited to physicians who meet certain qualifying requirements, and have notified the Secretary of Health and Human Services (HHS) of their intent to prescribe this product for the treatment of opioid addiction.
Source: buprenorphine.samhsa.gov
Cocaine is not an opioid drug. According to the approved product labeling, Suboxone® and Subutex® are indicated for the treatment of opioid addiction. In addition, under DATA 2000, codified at 21 U.S.C. 823(g), is limited to physicians who meet certain qualifying requirements, and have notified the Secretary of Health prescription use of Suboxone® and Subutex® in the treatment of opioid addiction and Human Services (HHS) of their intent to prescribe this product for the treatment of opioid addiction. ...
How much will a dose of buprenorphine cost a consumer?
The final cost to consumers of prescribed outpatient medication such as buprenorphine is determined by several parties: the pharmaceutical manufacturer, the insurer, the health plan (if any) or prescribing clinic, and finally, by the retail pharmacies that typically dispense the medication. ...
Source: buprenorphine.samhsa.gov
How does buprenorphine benefit you?
Buprenorphine can decrease cravings and relieve withdrawal symptoms. This can help you remain in treatment and gain control over your dependence without the distraction of cravings and fear of withdrawal.
Source: www.regionalnetwork.org
Is Buprenorphine a good solution to your opiate concerns?
Most people are concerned about detoxification from opiates due to having tried to detoxify on their own or in other programs and have had experiences that have been painful or anxiety provoking. With buprenorphine, the detoxification is, 99% of the time, very comfortable. Many of those patients who were considering detoxification under anesthesia (Ultra-Rapid Opiate Detoxification) are now opting for this more cost effective, less invasive form of comfortable detoxification from opiates. ...
Source: www.nabumed.com
Do you dispense LAAM or buprenorphine?
We do not dispense LAAM. Please call for the latest information on buprenorphine.
Source: www.forthelpmethadone.com
How do I find a doctor who prescribes buprenorphine for the treatment of opioid addiction?
D octors in each State who have waivers to prescribe buprenorphine for the treatment of opioid addiction are listed on the SAMHSA Buprenorphine Physician Locator Web site. Announcing SAMHSA Buprenorphine Locator: http://buprenorphine.samhsa.gov/bwns_locator/index.html
Where can I get a copy of the Buprenorphine Clinical Practice Guidelines?
Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction, Treatment Improvement Protocol (TIP) 40, is available via SAMHSA's National Clearinghouse for Alcohol and Drug Information (NCADI), or by calling 1-800-729-6686. It will also be available in the near future from the National Library of Medicine (NLM), or by calling 1-888-346-3656.
How do I verify that a physician is certified to prescribe buprenorphine?
When waivers are granted, physicians are issued special DEA numbers—that always start with an "X"—to be used on buprenorphine prescriptions. Physicians must write their "X" DEA number on all SUBOXONE and SUBUTEX prescriptions. There are a number of ways to verify that a physician has a valid waiver for prescribing buprenorphine: Check that the physicians' DEA number begins with an "X" Check the Substance Abuse and Mental Health Services (SAMHSA) Physician Locator . ...
Source: www.opioiddependence.com
Why use the buprenorphine/naloxone sublingual tablet for the treatment of opioid dependence?
Buprenorphine is a partial opioid agonist that suppresses opioid withdrawal symptoms and cravings (for more information, see Evolution of Opioid Dependence Treatment ). Naloxone is an opioid antagonist that is included to help deter diversion and misuse. When the buprenorphine/naloxone tablet is taken sublingually as prescribed, the naloxone is not absorbed into the bloodstream sufficiently to have any effect. ...
Source: www.opioiddependence.com
How can I contribute to patients' success with buprenorphine?
As a pharmacist, you are in a unique position to help local physicians implement office-based treatment of opioid dependence with buprenorphine. One of the most valuable functions that you provide is counseling patients. Patient Counseling Checklist Understand the importance of maintaining patient confidentiality Special federal regulations apply to the confidentiality of personally identifying information pertaining to substance abuse treatment (42 CFR Part 2) and the privacy of health records (HIPAA) Enhance patient ...
Source: www.opioiddependence.com
WHY IS BUPRENORPHINE BETTER THAN METHADONE FOR OPIATE/NARCOTIC ADDICTION?
Several reasons. Methadone must be distributed from a government licensed methadone treatment clinic where you must go on a daily basis to get medication. While this is a very effective treatment, many people find it inconvenient and embarrassing. With buprenorphine maintenance you are able to get your medication prescribed from a private physician's office and you are treated like any other patient with any other type of medical problem. Your treatment is confidential and you do not need to sign in. ...
What can you tell me about buprenorphine (Suboxone, Subutex)?
There is a new medication called buprenorphine (Subutex, Suboxone) that can be prescribed by doctors who have taken the proper training, but it may be difficult for some patients to switch from methadone to this medication. You should reduce your dose to 30 mg or less in order to switch over, or you could be thrown into withdrawal. If you are doing okay on 60 mg of methadone, you would probably do fine on buprenorphine. Anyone who needs more than 60 mg of methadone may not do well on buprenorphine. ...
Source: www.methadone-clinic.com
What can you tell me about buprenorphine?
There is a new medication called buprenorphine (Subutex, Suboxone) that can be prescribed by doctors who have taken the proper training, but it may be difficult for some patients to switch from methadone to this medication. You should reduce your dose to 30 mg or less in order to switch over, or you could be thrown into withdrawal. If you are doing okay on 60 mg of methadone, you would probably do fine on buprenorphine. Anyone who needs more than 60 mg of methadone may not do well on buprenorphine. ...
Source: www.methadonetoday.org
Do you offer Buprenorphine or Methadone?
No, we do not. However, we can suggest places where you could receive other treatments if that is the right choice for you.
Source: www.med.yale.edu
How do I find a physician to prescribe Buprenorphine?
Buprenorphine is a medication that is used to treat heroin and other opiate addiction. The Substance Abuse and Mental Health Services Administration (SAMHSA) has created an online directory of physicians who can prescribe Buprenorphine for opiate addiction. It is updated daily and contains the names, addresses and telephone numbers of those physicians who have received credentials from SAMHSA and an I.D. number from the Drug Enforcement Administration. ...
Source: www.jointogether.org
What is the trade name for buprenorphine, when used for detoxification in the U.S?
There are two forms of the sublingual tablet. One is called Suboxone. Suboxone is prescribed for detoxification from opiates. The other is called Subutex. Subutex is usually used for the first dose or doses of the detoxification. It is usually given by the doctor directly to the patient.
Source: www.nabumed.com
Can the medical personnel in correctional facilities dispense (or administer) buprenorphine to incarcerated individuals?
Qualified physicians who have obtained a DATA 2000 waiver can dispense or prescribe Subutex® or Suboxone® for addiction treatment in any practice setting, including in correctional facilities. Currently, State laws and policies vary considerably regarding opioid-assisted (methadone) treatment within correctional facilities. It is assumed that this same variation will occur with the use of buprenorphine in this setting. ...
Can a person currently being treated with methadone switch to buprenorphine without suffering withdrawal symptoms?
Patients can switch from methadone to buprenorphine treatment, but because the two drugs are very different, patients are not always satisfied with the results. A number of factors affect whether buprenorphine is a good choice for someone who is currently receiving methadone. It is also possible for patients receiving buprenorphine to be switched to methadone. Patients interested in finding out more about the possibility of switching treatment should discuss this with the doctor who is prescribing their medication.
Is there a limit on the number of patients a practitioner may treat with buprenorphine at any one time?
Yes. DATA 2000, as amended in December 2006, specifies that an individual physician may have a maximum of 30 patients on opioid therapy at any one time for the first year. One year after the date on which a physician submitted the initial notification, the physician may submit a second notification of the need and intent to treat up to 100 patients .
