Buprenorphine treatment: Your guide to the building blocks of OUD medication

Buprenorphine is a valuable tool in the fight against opioid addiction. Although it’s a widely used medication for addiction treatment, it’s common for people to have questions about it. This comes as no surprise—buprenorphine is available in many forms, both on its own and as a combination medication. Why is this ingredient such a big deal? Because it helps minimize cravings and withdrawal symptoms, making it easier for MAT patients to focus on the behavioral aspects of treatment and recovery.

This guide gets to the bottom of buprenorphine’s many forms and what prospective patients need to know about taking buprenorphine as a medication for opioid use disorder. Most importantly, we’ll address how it benefits patients during their treatment. Whether you're considering treatment for yourself or a friend or family member learning how to support a loved one as they undergo treatment for opioid use disorder, you’re in the right place.

How buprenorphine works

Buprenorphine is an FDA-approved partial opioid agonist that activates the same receptors as other opioids but not as intensely. Dosages are measured to treat cravings and withdrawal symptoms without producing the “high” provided by opioids or the respiratory depression associated with overdosing. Because partial agonists have a ceiling effect not found in full agonists, they’re considered safer for patients with less potential for misuse.

Given these benefits, doctors often prescribe buprenorphine to help patients discontinue full agonist opioid use.

The different types of buprenorphine

Buprenorphine typically reaches full effect within one to two hours, though its duration in the body depends on how it’s administered. These are the forms of buprenorphine you may encounter:

• Sublocade®: Buprenorphine doctors administer Sublocade as a monthly injection to provide a continuous release to help manage cravings and withdrawal symptoms. The sustained-release formula also means that Sublocade has a half-life of up to 43 days and may take months for the body to eliminate it.
• Subutex®: This is a tablet form of buprenorphine, but unlike many oral medications that are swallowed, Subutex is a sublingual formula. It is placed under the tongue and allowed to dissolve; chewing the tablet will make it less effective. The tablet itself is small and white and is usually round, oval, or hexagonal. Subutex has a half-life of 24 to 48 hours and takes between five and eight days to be eliminated from the body.

Combination buprenorphine treatments

Buprenorphine can also be combined with naloxone, a medication that blocks the euphoric effects of opioids and counteracts withdrawal symptoms. Currently, there are two combination buprenorphine-naloxone medications on the market:

• Suboxone®: First approved by the FDA in 2002, Suboxone is considered safer than buprenorphine alone because it also contains naloxone, which discourages snorting or intravenous misuse of buprenorphine. The medication is available as both sublingual films and tablets.
• Zubsolv®: This updated formulation was approved by the FDA in 2013 as an alternative to Suboxone, offering faster dissolution for better bioavailability. Zubsolv comes in a round, white tablet that states the dosage on one side with “OM” printed on the other.

Buprenorphine clinics typically prescribe these combination medications to manage cravings and withdrawal symptoms. However, Suboxone is the more commonly prescribed option and is touted as the gold standard of OUD care. It starts working within 20 to 60 minutes and remains effective for several hours.

When a combination medication is taken correctly, the naloxone remains inactive. However, if misused, it becomes active to quickly block the effects of opioids, including signs of overdose.

The benefits of buprenorphine treatment

Better support for recovery

The use of medication is a significant advancement in treating OUD. The increasing potency of heroin, fentanyl, and other drugs can make detoxing difficult to manage.

Increased patient safety

One of the main differences is regulation. Methadone is a Schedule II substance, while buprenorphine is Schedule III, allowing practitioners to prescribe the drug for home use.

Positive effects on physical + mental health

Buprenorphine has been used for more than OUD treatment. In 1984, certain formulations were FDA-approved for pain management because the drug can block pain signals.

Greater long-term outcomes

Long-term Suboxone use offers stability and helps reduce the risk of relapse when paired with proper clinical support.

How to start buprenorphine treatment at Ophelia

Starting with Ophelia

Your first interaction as a patient with Ophelia will be a welcome call with our Enrollment team. This skilled group will help you work through paperwork, red tape, and scheduling. Afterward, you’ll meet with a clinician who will gather your medical history as well as important details about your life in order to find the best buprenorphine treatment plan for you.

Induction

Once the above details are squared away, it’s time to start induction. Induction is the critical first step in buprenorphine treatment. During induction, you work with your clinician to find the right dose of buprenorphine to alleviate symptoms of withdrawal and opioid cravings while not causing strong side effects.

Stability after induction

Once induction is over, you’ll switch to a different dose of medicine and begin taking it regularly under the advice of our Clinical team.

Buprenorphine treatment FAQ

Buprenorphine is one of the three medications the Food and Drug Administration (FDA) has approved to treat opioid use disorder (OUD). Clinicians and care teams use it as part of their evidence-based, comprehensive treatment plans to help those struggling with opioid dependence.

What is precipitated withdrawal?

Precipitated withdrawal can occur when someone who is actively dependent on opioids takes an opioid agonist or partial agonist, like buprenorphine. During precipitated withdrawal, the patient experiences a sudden onset of intense withdrawal symptoms.

Can you take buprenorphine after surgery?

Patients using medications for addiction treatment (MAT) often wonder if they can continue using that medication during and after surgery. New research suggests that patients should continue using buprenorphine to manage their OUD even before and after surgery.

Will buprenorphine affect blood pressure?

The good news is that buprenorphine does not cause high blood pressure.

Will buprenorphine affect oral health?

Over 40% of adults in the United States report experiencing some mouth pain in the last year. While some versions of buprenorphine are sublingual medications, the benefits of taking buprenorphine to treat OUD outweigh the risks of dental problems.

Can you still take OTC medications on buprenorphine?

In many cases, patients can continue to use at least OTC medications while taking buprenorphine.

How do you know your dosage is right?

Selecting the correct dosage is just as important as choosing the proper medication.

What happens if you miss a dose?

Patients should take the recommended dosage consistently at the specified time.

Can women use buprenorphine during pregnancy?

Pregnant women can safely use buprenorphine and other medications for addiction treatment throughout their pregnancies.

Can you microdose buprenorphine?

Microdosing buprenorphine may make precipitated withdrawal less likely.

Are there buprenorphine medications other than Suboxone and Subutex?

There are several other options for buprenorphine medications beyond Suboxone and Subutex.