What is Buprenorphine?
Buprenorphine, the primary ingredient found in Bunavail, Subutex, Suboxone, and Zubsolv, is a semi-synthetic opioid and partial agonist that is used in the treatment of opiate addiction. Unlike heroin, methadone, and other opiates, buprenorphine does not cause respiratory depression. This is the only major difference between methadone and buprenorphine, however, and people who are entering detox treatment, either short or long-term, tend to go for whichever is their personal preference.
Buprenorphine Brand Names
Most commonly prescribed among the buprenorphine meds, Suboxone is actually a combination of buprenorphine and naloxone. Naloxone, an antagonist, is the active ingredient in Narcan. Narcan, in turn, is more popularly known for “saving lives”, an overdose revival medication.
The presence of Naloxone in Suboxone discourages users from shooting it up because the Naloxone will only cause them to experience immediate withdrawal symptoms. This combination effectively prevents the misuse of buprenorphine. In comparison, Subutex is pure buprenorphine.
It can be injected and users can expect no unpleasant consequences. Subutex, therefore, has a high potential for abuse and isn’t often prescribed to patients. Bunavail also contains naloxone, but with less naloxone as compared to Suboxone. It comes in the form of an oral film that dissolves in the mouth. Zubsolv, another buprenorphine/naloxone combo, has a lower starting dose compared to Suboxone, Subutex, and Bunavail. As a result, it has become a frontrunner in the treatment of opiate dependence in pregnant patients.
History of Buprenorphine
Buprenorphine was first manufactured in 1969 by Reckitt & Colman (Reckitt Benckiser today). It was the culmination of a decade-long effort to create a semi-synthetic opiate. It was touted as a drug that can produce the desired effects of morphine while reducing the undesirable effects, like an addiction; allowing it to be used in human trials by 1971.
Buprenorphine Drug Fact Infographic
In 1978, an injectable form of buprenorphine was introduced in the UK as the treatment for acute pain. Shortly thereafter in 1982, an orally-administered alternative came out. It took another 20 years before the US FDA finally approved buprenorphine in October 2002 for the treatment of opioid addiction. This was after the Drug Addiction and Treatment Act of 2000 passed, under which trained physicians were allowed to use Schedule III, IV, and V narcotics to detoxify patients and treat addiction in outpatient settings. Initially, the legislation mandated that each certified physician be allowed 10 buprenorphine patients under their care. While this number has since been increased to 100 per physician, many more opiate addicts unable to get treatment because there still not enough openings. Another increase is on the horizon, having passed recent legislation that makes raises this number to 200, but it has yet to be implemented.
Screening Cut-Off and Detection Time
In drug testing, the cut-off level separates a negative and a positive test result. The cut-off levels set at that point where drug detection happens with the smallest probability for false positives. It is imperative to note that a negative sample does not automatically mean that it does not contain any drug – it only indicates that it may contain a drug at such a low concentration that it is below the established cut-off.
- Specimen Concentration Detection Time
- Urine Drug Test 10 ng/ml 3-6 days
- Saliva Drug Test 10 ng/ml up to 48 hours
- Hair Drug Test 500 pg/mg up to 90 days
Buprenorphine Drug Type
Buprenorphine is a narcotic analgesic. These types of drugs relieve acute and chronic severe pain, cause numbness, and induce sleep or a state of unconsciousness. They bind to opioid receptors present in the peripheral and central nervous systems. Narcotic analgesic drugs tend to cause tolerance and dependence.
Forms and Routes of Administration Buprenorphine Methods of Ingestion Buprenorphine comes in different forms and is administered via different routes, as follows: Oral – The drug is swallowed and is allowed to undergo the metabolic process. Orally-administered buprenorphine comes in tablet form. Sublingual – The drug is allowed to be diffused into the bloodstream through the tissues under the tongue. Buprenorphine for sublingual administration come in tablet or film forms.
Buccal – Buprenorphine comes in the form of a film and is administered topically on the inside of the cheek (buccal area) to diffuse through the tissues that line the mouth (oral mucosa) from where it directly enters the bloodstream. Buccal administration takes effect faster than oral administration because the drug does not pass through the digestive system and therefore does not undergo metabolism. Transdermal – The buprenorphine transdermal patch is applied to the upper chest, upper outer arm, upper back or the side of the chest (either side).
Injection – Buprenorphine comes in an injectable (liquid) form, either single 1ml vials/ampules of multi-dose 50-ml bottles. They can administered either intramuscularly (IM) or intravenously (IV). Intranasal – Users believe that snorting buprenorphine pills by crushing it into powder form takes effect faster than putting it under the tongue, the way the pills are meant to be used. By snorting, the drug is absorbed into the bloodstream through the nasal mucosa.
DEA Drug Class
Buprenorphine controlled under Schedule III of the Controlled Substances Act. Schedule III lists drugs, substances or chemicals that:
- have a lower potential for abuse compared to Schedule II drugs;
- have a currently accepted medical use in treatment in the U.S.;
may lead to moderate psychological or physical dependence compared to Schedule II drugs. Other Schedule III drugs include:
- Anabolic Steroids
- Barbiturates (Short-acting)
- Lysergic Acid Amide (LSA)
Schedule III drugs are prescription-only drugs and prescriptions are only valid for use up to 6 months from the date of issue. Brand Names for Buprenorphine
- Buprenorphine Systemic
- Butrans (transdermal)
- Buprenorphine/Naloxone Systemic
- Street Names for Buprenorphine
- Stop signs
- Box or Boxes
- Sub or plural Subs
- Uses for Buprenorphine
Medical/Therapeutic Uses for Buprenorphine
Aside from the treatment of chronic pain, buprenorphine is used in MATs or Medication Assisted Treatment – programs that use other drugs to help people treat/manage opiate addiction or reduce/quit their use of heroin or other opiates (pain relievers/morphine). In proper doses, buprenorphine treatment may accomplish the following:
- Decrease opioid cravings
- Suppress symptoms of opioid withdrawal
- Block the effects of other opioids
- Helps patients stay in treatment
- Reduce illicit opioid use
- Helps curb the spread of HIV that occurs thru injection drug use
Recreational Use of Buprenorphine
Buprenorphine is no different from other opioids. It also commonly abused because it produces significant euphoria. People use it illegally as a substitute for heroin, or as a primary drug of abuse.
Short-Term Side Effects of Buprenorphine
Short-term side effects of buprenorphine use are rare and low-dose related. They also considered milder than those caused by other opioids.
- Constipation (more common at higher doses)
- Dizziness (more common at higher doses)
- Feelings of fatigue or weakness
- Mild perspiration
- Nausea (more common at higher doses)
Long-Term Side Effects of Buprenorphine
Buprenorphine has not been around for very long so there are no extensive studies yet as to its long-term effects. However, experts believe these effects may be similar to those of other more well-researched opioids. Once usage stops, some long-term effects may persist, as follows:
- Decreased pain tolerance
- Decreased sex drive
- Dry mouth
- Isolation and avoidance of social situations
- Menstrual problems
- Mood problems
- Physical weakness
Buprenorphine can be highly addictive, especially when misused. When patients begin taking them in excess of the proper dose, they begin to develop tolerance, progressively needing more and more of the drug to achieve the same desired effect. As a result, withdrawal symptoms begin to felt more quickly, which makes the user feel very ill. Addiction signs and symptoms include:
- A constant need for the drug
- Low blood pressure
- Rigid muscles
- Runny nose
- Slowed breathing
- Using higher doses of the drug
When a person suddenly stops using buprenorphine, withdrawal symptoms may appear, but not as intense as those caused by other opioid drugs. Buprenorphine is a long-acting drug so the withdrawal symptoms will not begin right away. The symptoms often described as flu-like and typically peak within a few days of cessation. The first 24 to 72 hours – this is the most intense period of withdrawal.
The symptoms that often appear during this period include sweating, nausea, irritability, restlessness, joint and muscle aches, watery eyes, diarrhea, and dilated pupils. 72 hours to one week – after the first 72 hours, the aches will continue accompanied by insomnia, cramps, mood swings, all-around restlessness, and general feelings of malaise. The second week – Buprenorphine withdrawal symptoms begin to fade but some people may still experience restlessness, mood swings, and low motivation.
The third week – The physical symptoms should resolved by this time, but some people may continue to experience issues with motivation, mood, and restlessness. Others may also begin cravings for the drug.
Facts and Statistics
According to the Drug Abuse Warning Network, an estimated 21,483 ER visits were associated with nonmedical use of buprenorphine in 2011, nearly 5x the estimated number of in 2006. In 2011, the American Association of Poison Control Centers reported 3,625 cases and three fatalities from toxic exposure to buprenorphine. More users have succeeded in overcoming their opioid addiction from using Suboxone compared to methadone or placebo pills. Buprenorphine has 30-50 times the analgesic potency of morphine.
Can I Purchase a Single Use Drug Test for Buprenorphine?
Ovus Medical offers Drug Tests in Bulk, or for single use. If you are concerned about how someone will fare on a Drug Test, or simply wish to test yourself, it’s a fairly easy process taking only a few minutes. Our Single Use 12 Panel Urine Drug Test tests for 12 commonly abused drugs, including Buprenorphine.
After the donor seals the urine in the leak-proof container, it then handed off to the evaluator. What makes the process streamlined is that the strips used to indicate the test results sealed within the container. For hygiene reasons, this is ideal. When it is time to view the test results, the evaluator simply peels away the outside label revealing the drug test strips with each individual result.
The test results within the Drug Test will show results within a few minutes. Results should evaluated within 5-8 minutes. Results should not evaluated after 1o minutes. The 12 Panel Drug Testing Kits designed to detect 12 of the most abused and commonly used drugs. However, depending on your needs, you can purchase other kits that test for different drugs. For instance, the 13 Panel Drug Testing Cup includes all the same drugs tested within a 12 Panel Drug Test with the addition of the drug Fentanyl (FYL). There are also variants of the typical 12 Panel Drug Test that include drugs like phencyclidine, or PCP. If you have any questions or concerns regarding our product or wish to place an order, feel free to call us.