Incorporating medications with therapy.

Bintaday Behavioral Health Care provides Buprenorphine as a part of a combination of our counseling, behavioral therapies and whole-patient approach to the treatment of opioid dependency. When taken as prescribed, buprenorphine is safe and effective. Buprenorphine was approved for clinical use in October 2002 by the Food and Drug Administration (FDA), buprenorphine represents the latest advance in medication-assisted treatment (MAT). Medications such as buprenorphine, in combination with the services provided by a team of providers like the Bintaday Behavioral Health Care team can make this process more effective and efficient. When taken as prescribed, buprenorphine is safe and effective.

As with all medications used in MAT, buprenorphine is prescribed as part of a comprehensive treatment plan that includes counseling and participation in social support programs.

Buprenorphine offers several benefits to those with opioid dependency and to others for whom treatment in a methadone clinic is not preferred or is less convenient. The FDA has approved the following buprenorphine products:

• Bunavail (buprenorphine and naloxone) buccal film
• Suboxone (buprenorphine and naloxone) film
• Zubsolv (buprenorphine and naloxone) sublingual tablets
• Buprenorphine-containing transmucosal products for opioid dependency

How Buprenorphine Works
Buprenorphine has unique pharmacological properties that help:

• Lower the potential for misuse
• Diminish the effects of physical dependency to opioids, such as withdrawal symptoms and cravings
• Increase safety in cases of overdose

Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression. With buprenorphine, however, these effects are weaker than those of full drugs such as heroin and methadone.

Buprenorphine’s opioid effects increase with each dose until at moderate doses they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects. Also, because of buprenorphine’s long-acting agent, many patients may not have to take it every day.

Side Effects of Buprenorphine

Buprenorphine’s side effects are similar to those of opioids and can include:

• Nausea, vomiting, and constipation
• Muscle aches and cramps
• Cravings
• Inability to sleep
• Distress and irritability
• Fever

Buprenorphine Safety
Participants should use the following precautions when taking buprenorphine:

• Do not take other medications without first consulting your doctor.
• Do not use illegal drugs, drink alcohol, or take sedatives, tranquilizers, or other drugs that slow breathing. Mixing large amounts of other medications with buprenorphine can lead to overdose or death.
• Do ensure that a physician monitors any liver-related health issues that you may have.

Pregnant or Breastfeeding Women and Buprenorphine
Limited information exists on the use of buprenorphine in women who are pregnant and have an opioid dependency. But the few case reports available have not demonstrated any significant problems resulting from use of buprenorphine during pregnancy. The FDA classifies buprenorphine products as Pregnancy Category C medications, indicating that the risk of adverse effects has not been ruled out.

Treatment with Buprenorphine
The ideal candidates for opioid dependency treatment with buprenorphine:

• Have been objectively diagnosed with an opioid dependency
• Are willing to follow safety precautions for the treatment
• Have been cleared of any health conflicts with using buprenorphine
• Have reviewed other treatment options before agreeing to buprenorphine treatment

Buprenorphine treatment happens in three phases:

1. The Induction Phase is the medically monitored startup of buprenorphine treatment performed in a qualified physician’s office or certified OTP using approved buprenorphine products. The medication is administered when a person with an opioid dependency has abstained from using opioids for 12 to 24 hours and is in the early stages of opioid withdrawal. It is important to note that buprenorphine can bring on acute withdrawal for patents who are not in the early stages of withdrawal and who have other opioids in their bloodstream.
2. The Stabilization Phase begins after a patient has discontinued or greatly reduced their misuse of the problem drug, no longer has cravings, and experiences few, if any, side effects. The buprenorphine dose may need to be adjusted during this phase. Because of the long-acting agent of buprenorphine, once patients have been stabilized, they can sometimes switch to alternate-day dosing instead of dosing every day.
3. The Maintenance Phase occurs when a patient is doing well on a steady dose of buprenorphine. The length of time of the maintenance phase is tailored to each patient and could be indefinite. Once an individual is stabilized, an alternative approach would be to go into a medically supervised withdrawal, which makes the transition from a physically dependent state smoother. People then can engage in further rehabilitation—with or without MAT—to prevent a possible relapse.

Treatment of opioid dependency with buprenorphine is most effective in combination with counseling services, which can include different forms of behavioral therapy and self-help programs. At BK Behavioral Health Center, our providers with will be with you every step of the way.

Do you have more questions? Please let us know by sending us a message or reaching out to us through our given contact information.