Buprenorphine (Belbuca) can be taken both legally and illegally. Doctors prescribe it to relieve severe pain in people who need constant analgesic medication for an extended period of time and are unable to take other forms of painkillers.
Buprenorphine and the combination of buprenorphine and naloxone (Suboxone) is often prescribed to treat dependence on opioid drugs, such as narcotic painkillers and heroin. Buprenorphine fools the brain into thinking it is still getting the opioid of addiction. As a result, the person taking buprenorphine feels normal, but not high, so that withdrawal symptoms do not occur.
However, as it can be habit-forming, buprenorphine must be taken exactly as prescribed by a doctor, and under a doctor’s supervision. Buprenorphine abusers often inject or snort the drug for a more intense effect, and/or take it in combination with other drugs, such as benzodiazepine—a combination that can be deadly.
Understanding Buprenorphine Abuse
Buprenorphine is a synthetic opiate. Taking the drug can produce the pain-relieving, euphoric, and sedating effects associated with other opiates, but it does not result in the same level of sedation and respiratory depression, or cause as much impairment to cognitive or motor skills. Buprenorphine also has a “ceiling effect,” which means that larger doses of the drug do not create a larger effect, making it much less useful for getting high than more commonly addictive opioids such as heroin.
However, because buprenorphine does produce a euphoric effect, it is still susceptible to abuse, and when taken in high doses, will cause withdrawal symptoms. You should not suddenly stop taking buprenorphine; the dosage must be carefully tapered off.
According to the U.S. National Library of Medicine, even taking buprenorphine as directed can cause a number of side effects such as headache, stomach pain, constipation, difficulty falling asleep or staying asleep, mouth numbness or redness, tongue pain, blurred vision and back pain. Contact a doctor if these symptoms become severe or won’t go away.
More serious side effects may also occur. Call a doctor or seek emergency treatment if you experience any of the following while on buprenorphine:
- hives, rash, or itching
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- nausea, vomiting, loss of appetite, weakness, or dizziness
- inability to get or keep an erection
- irregular menstruation
- decreased sexual desire
- slowed breathing
- upset stomach or pain in the upper right part of the stomach
- extreme tiredness or lack of energy
- blurred vision
- slurred speech
- unusual bleeding or bruising
- yellowing of the skin or eyes
- dark-colored urine or light-colored stools
Signs and Symptoms of Buprenorphine Abuse
Signs of buprenorphine abuse may include:
- Running out of the medication before the prescription is due for refill
- Taking buprenorphine without a prescription
- Injecting or snorting buprenorphine
- Taking it in combination with other drugs, such as benzodiazepine
- Secretive behavior
- Unusual actions or physical symptoms
- New difficulties in relationships
Dangers of Buprenorphine Abuse
Abuse of buprenorphine can be dangerous in a variety of ways.
Symptoms of buprenorphine overdose may include the following:
- slowed or difficulty breathing
- extreme sleepiness or drowsiness
- coma (loss of consciousness for a period of time)
- slow heartbeat
- cold, clammy skin
- muscle weakness
- narrowing or widening of the pupils (black circles in the center of the eye)
- unusual snoring
Who Abuses Buprenorphine?
Individuals in treatment for addiction are unlikely to abuse buprenorphine, because they will not be able to “get high” from the drug in the same way that they can with their drug of choice. However, some recovering addicts have developed addictions to buprenorphine by failing to take the medication as instructed.
People taking buprenorphine for pain are at risk of abusing the medication if they fail to follow the prescription instructions, or take more than the recommended amount.
According to the Drug Enforcement Administration, in countries where buprenorphine has gained popularity as an illicit street drug, it is sought by a wide variety of users: young naive individuals, non-addicted opioid abusers, heroin addicts and buprenorphine treatment clients.
Because buprenorphine is capable of producing significant euphoria, it has gained popularity as a heroin substitute and as a primary drug of abuse.
When it is used appropriately, under a doctor’s instructions, this medicine can be beneficial, and improve a patient’s quality of life. But overuse and abuse of buprenorphine will lead to addiction, and serious mental and physical consequences.
Anyone, from any walk of life, can become addicted to buprenorphine, although the drug is somewhat difficult to obtain as a street drug. Most often an individual must have some sort of connection to an addiction treatment doctor or facility, or to another person who does, in order to obtain it. When purchased illicitly, the drug is expensive.
Because this medication is prescribed by doctors to combat drug abuse, users often believe that buprenorphine is non-addictive. This is a hazardous misconception. Buprenorphine is only safe when it is used in a precise dosage, as determined by a medical doctor, to prevent opioid withdrawal symptoms or to treat pain. When you use buprenorphine inappropriately, or to get high, addiction occurs.
Am I Addicted to Buprenorphine?
If you fear that you are addicted to buprenorphine, read and honestly answer the following questions:
- Do I take buprenorphine as directed by my doctor?
- Do I abuse the drug in order to combat feelings of unhappiness, loneliness, depression, etc.?
- Have friends or family members mentioned more than once that they are worried about my drug use?
- Do I become hostile or angry when they do so?
- Do I ever experience withdrawal symptoms such as those listed above?
- Am I secretive about my drug use, lying about when I use or how much I take?
- Have I experienced any major problems in the last year, such as a breakup, job loss, car accident, family problems, financial problems, or getting arrested as a result of my drug use?
- Do I snort or inject buprenorphine?
- Do I take buprenorphine in combination with benzodiazepine?
If you answered yes to one or more of these questions, you may be addicted to buprenorphine and in need of professional help.
Buprenorphine Addiction Treatment
Addiction is a chronic, relapsing disease. The NIDA explains that “repeated drug use changes the brain, including parts of the brain that enable you to exert self-control. These and other changes can be seen clearly in brain imaging studies of people with drug addictions.”
This is why addicts require professional help to break the cycle of addiction. The substance abuse specialists at a qualified drug and alcohol treatment center are trained in how to manage addiction and lead addicts safely to recovery.
Detoxification is the first step to any recovery plan. A person needs clarity of mind and a body free from addictive substances before they can fully recover. Because it is so dangerous to abruptly stop taking buprenorphine, detox should take place under the guidance of medical professionals who can instruct you on the safest way to taper the dosage, slowly weaning you off the drug.
Addicts who have abused buprenorphine in the past are likely to do so again in the future, and may need to avoid drug-assisted detoxification.
Addicts may receive inpatient residential treatment for their addiction, and/or outpatient treatment. No matter what type of recovery plan they choose, all substance abuse treatment will include talk therapy.
Individual therapy allows for patients to work privately on issues specific only to them, while group therapy allows them to both support and receive support from fellow addicts who are experiencing similar struggles. Family therapy is a valuable tool to ensure individuals will have the best environment possible at home, to prevent relapse.
Other treatment options include:
- Cognitive-behavioral therapy: CBT teaches patients to retrain their brains with new methods of coping with stress and cravings, and avoiding trigger situations
- 12-step meetings: Meetings based on the 12-step program that originated with Alcoholics Anonymous are an invaluable resource to support long term sobriety.
- Treatment for co-occurring conditions: most addicts suffer from undiagnosed mental health issues that underlie and fuel their substance abuse. These co-occurring disorders must be addressed as a part of recovery.
- Nutrition, fitness and recreational therapy: a strong body is just as important as a strong mind when it comes to long-term recovery. The better a person feels, the more prepared they will be to handle life as it comes.