Wednesday September 20th 2017

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Physical addiction to buprenorphine

Is buprenorphine addictive?

Yes. Buprenorphine is addictive.

But wait. Isn’t buprenorphine supposed to be used to treat opiate addiction?

The fact is: buprenorphine is a psychoactive drug. While most people only develop physical dependence on the opiate replacement medication, others can experience full-blown addiction. So, what’s the difference between the two? Where can you draw the line between regular use and harmful use?

We review the difference between dependence and addiction here. Then, we outline clear signs of both. Finally, we describe where you can go for help. So, if you’re questioning whether or not buprenorphine is a good fit for you…keep reading! We hope to answer your questions here. If you still have questions, we invite you to leave them in the comments section at the end.

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How does buprenorphine work?

Buprenorphine it is a partial opioid agonist. It works by binding to nerve receptors in the central nervous system. As buprenorphine occupies these nerves, stronger drugs like heroin, oxcodone, hydrocodone, or morphine cannot produce strong euphoric effect.  As a result, regular therapeutic dosing is associated with lower levels of drug craving and lower rates of relapse.

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Additionally, buprenorphine is known to produce a milder degree of physical dependence. It also manifests a less intense withdrawal syndrome in comparison to stronger opiates. However, buprenorphine dependence is still possible, especially when it’s abused.

So, what does drug dependence look like?

Drug dependence

Dependence occurs for all individuals who take buprenorphine regularly and for a prolonged period of time, even in those who take it exactly as prescribed. In fact, it is an expected and natural response of continued buprenorphine use. In other words: you become physically dependent on buprenorphine as a consequence of repeated use.

Dependence is marked by two evident physical changes:

1. Tolerance – With continued use, once effective doses of buprenorphine seem to lose their potency. As tolerance increases, users feel a need to take higher doses in order to achieve the desired effects, a practice that can lead to addiction if not monitored by a medical professional.

2. Withdrawal – As your body becomes dependent on buprenorphine, it will go through withdrawal whenever your regular dose is reduced or discontinued. The usual buprenorphine withdrawal symptoms include restlessness, nausea, vomiting, and diarrhea.

Does dependence = addiction?

No. Physical dependence is very different from addiction to buprenorphine.

Addiction is a chronic, relapsing brain disease. Its main characteristic is using buprenorphine for euphoric effect, or to get high. How do you identify it? Addiction is primarily recognized by a set of changes in a person’s behavior and mood. These changes are usually caused by the biochemical processes in the brain which occur with continued substance abuse.

Abuse increases risk of addiction

Most people who use buprenorphine as described are not at risk of developing addiction to it. They may become physically dependent on the medication. However, they will probably not experience compulsion to use it as a way to cope with life.

Instead, if you are taking buprenorphine to get high…you can become addicted to it. If you use buprenorphine in any way other than prescribed, you risk addiction. So if you try to inject, snort, or otherwise change the way buprenorphine gets to the brain, you can become psychologically hooked on its effects.

Abuse potential

The abuse potential of buprenorphine is determined by:

  • Your frequency and dose of use.
  • The drug’s half life.
  • How fast the drug reaches the brain.
  • Your route and mode of administration.

A faster route of administration, will result in a shorter half life. Faster onset of action is associated with a higher abuse potential of buprenorphine.

Who’s at risk of buprenorphine addiction?

There are a multitude of genetic, social, and environmental factors that can make someone be more easily susceptible to the addictive properties of buprenorphine…while others seem to have no problem using the medication for years on end. Some of the factors that influence a person’s risk of addiction include:

  1. A history of drug abuse or addiction.
  2. Having parents with a history of drug abuse.
  3. Your individual brain response to opioids and other drugs.
  4. Severe physical or psychological trauma.
  5. Mental health conditions that co-occur with addiction.

Physical signs of addiction

Classic signs of buprenorphine addiction are like those of any addiction. People who are addicted to opioid drugs cannot control their use, continue using the drug despite harm, and experience cravings. Furthermore, the physical signs and symptoms of a buprenorphine problem are similar to those of other opiates and opioids. They may include:

  • abnormal responses to stress
  • constricted pupils
  • fever
  • hair loss
  • increased blood pressure
  • insomnia
  • muscle pain and cramps
  • nausea
  • slurred speech
  • sweating
  • vomiting

However, there is also a number of psychological and behavioral signs of addiction that are usually more easy to detect, such as:

  • apathetic mood
  • continued use of buprenorphine despite negative outcomes
  • depression
  • inability to control the compulsive use of buprenorphine
  • inability to deal with emotions
  • loss of interest in sex
  • poor memory
  • preoccupation with obtaining or consuming buprenorphine
  • strong buprenorphine cravings

Recognize two or more of these signs and symptoms of buprenorphine addiction? No need to feel ashamed or guilty! Remind yourself that addiction is a medical condition, and as such it responds to pharmaceutical and therapeutic interventions. Then, reach out for help…

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Treating a buprenorphine problem

Physical dependence is not a dangerous medical condition. It can be resolved during a tapering process or supervised in a medical detox clinic. Addiction, on the other hand, is a disorder that can have detrimental effects on your life and requires treatment. What does treatment entail?

First, you’ll need an official diagnosis from a medical expert. Brief assessments are a good place to start. These standardized questions or interviews can be administered by:

  • A Clinical Social Worker
  • A Doctor who specializes in addiction
  • A Family Doctor
  • A Psychotherapist
  • A Psychiatrist

Once you have a diagnosis, a reputable treatment center will work with you to create an individual treatment plan. While many modalities can be customized to your specific case, the process remains the same for everyone. The three main stages of buprenorphine addiction treatment are:

STAGE 1: Medical detoxification and withdrawal. The physical symptoms of buprenorphine addiction occur as the drug leaves the system and require medical care and assistance. Detox clinics offer professional medical supervision during buprenorphine withdrawal. Moreover, these clinics can also provide over-the-counter medications to address symptoms and may even prescribe medications if necessary.

STAGE 2: Physical stabilization. As the acute phase of detox ends, your physical state will starts to normalize. At this time, you can still expect to be monitored and supported by clinical doctors and nurses. In addition, they can administer medications for opioid withdrawal symptoms that can lessen, manage, and minimize any possible risks and discomfort.

STAGE 3: Psychological interventions. Addiction is not resolved once your body gets rid of buprenorphine. You’ll need to get to the root of why you use the drug as an escape. During treatment, you’ll mainly explore this via individual and group counseling. In fact, ongoing therapy sessions be extended for 9-12 months even after you leave the rehab facility.

Get Help For Buprenorphine Addiction

Help for buprenorphine addiction is most successful when a program is individualized and constructed in accordance to your personal needs and goals. Generally, successful buprenorphine addiction treatment programs employ a combination of medical and psychological support.

How can you get help?

1. Your first point of contact can be your physician that can refer you to local treatment resources.
2. You can contact SAMHSA’s national helpline to get referrals to programs in your living area.
3. You can search online or contact a rehab facility directly (word of mouth can help you make a decision).
4. You can CALL 1-877-721-2951 to get professional advise and guidance on finding appropriate addiction treatment options for your unique needs.

Once you enter a treatment program, therapy and counseling can help you address underlying issues that lead you to develop a buprenorphine use problem in the first place. During psychotherapy, you learn how to handle stress without turning to drugs, and how to change and adjust to a new drug-free lifestyle.

Continued help is also important and will allow you to work on your recovery from buprenorphine addiction. Sources of continued support and treatment include:

  • Support groups
  • Family therapy
  • Individual behavioral therapy/Psychotherapy

Got something to ask?

Do you still have questions about buprenorphine’s physical addiction potential? Please leave them here. We are happy to help answer your questions personally and promptly. If we do not know the answer to your particular question, we will refer you to someone who does.

Reference Sources: NCBI: Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction.
NCBI: Buprenorphine’s physical dependence potential: antagonist-precipitated withdrawal in humans
NAABT: Is buprenorphine treatment just trading one addiction for another?

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