Buprenorphine Treatment at HCRC
At Health Care Resource Centers (HCRC), we offer Medication-Assisted Treatment (MAT) with buprenorphine through our office-based opioid treatment (OBOT) programs. Designed to feel like a regular doctor’s office, our OBOT programs provide a comfortable and convenient setting for treating opioid use disorder. Available at select locations across Massachusetts, Connecticut, New Hampshire, and Maine, our approach aims to make recovery as easy as possible.
Our OBOT program focuses on treating opioid use disorder using medications that contain buprenorphine to reduce cravings and alleviate withdrawal symptoms. Unlike some traditional opioid treatment programs that require daily visits to the clinic, our program offers more flexibility. After your initial consultation, your provider will prescribe the medication, which you can have filled at a local pharmacy. This approach reduces the number of required visits to our treatment center, allowing you to maintain your recovery with greater convenience and freedom.
What Is Buprenorphine?
Buprenorphine (found in medications like Suboxone, Sublocade, and Zubsolv) is commonly used to treat opioid use disorder. It is a synthetic drug that partially activates opioid receptors in the brain, but to a much lesser degree than opioids. This helps reduce cravings and withdrawal symptoms. Buprenorphine can also lessen feelings of tiredness caused by opioids, while reducing the risk of overdose.
Buprenorphine is usually given as an extended-release tablet that dissolves under the tongue (sublingually), but it can also be administered through other methods, like injections or under the skin (subcutaneously). A common version, Suboxone, combines buprenorphine with naloxone, an opioid-receptor blocker, to enhance the treatment and make its effects last longer.
Benefits of Buprenorphine
Buprenorphine is an effective and FDA approved medication for treating opioid addiction, in use since October 2002. It is a long-acting medication, meaning you may only need to take it once a day, and its effects last for about 24 hours or more. When taken as directed and with the proper safety measures, the risk of overdose is very low.
Key Benefits of Buprenorphine:
- Convenient daily dosing: Only one or two doses per day are needed, making it easier to manage. In many cases these days, patients who are prescribed daily administration of Buprenorphine are given split doses in AM and PM. Patients seem to prefer having that crutch in the evening when stress seems to seep into the mind.
- Long-lasting effects: Provides relief from cravings and withdrawal symptoms for 24 hours or longer.
- Low risk of overdose: Safe when used as prescribed, with minimal risk compared to other opioids.
Comparing Buprenorphine and Methadone
Buprenorphine and methadone share some similarities. Both are opioid medications commonly prescribed by doctors for similar reasons, and they have similar side effects. However, there are also important differences between them, and the treatment experience with methadone can be quite different from that with buprenorphine.
Differences Between Buprenorphine Treatment and Methadone Treatment
Some research suggests that patients in MAT with buprenorphine are less likely to use opioids outside of their treatment. Studies also show that buprenorphine may lead to reduced cocaine use, cravings, anxiety, and heart problems, along with higher treatment satisfaction compared to methadone. Below are some other key differences between these two medications.
Receptor Activation
Both buprenorphine and methadone help reduce withdrawal symptoms by mimicking the effects of opioids. However, buprenorphine is a partial opioid agonist, meaning it activates the brain’s opioid receptors less than full agonists like methadone or illicit opioids. This allows both medications to satisfy the brain’s craving for opioids while minimizing the risks of illicit opioid use.
“Ceiling Effect”
Buprenorphine has a “ceiling effect,” meaning it produces a limited amount of euphoria, even if you take more. Methadone, on the other hand, increases its euphoric effects the more you take. This ceiling effect in buprenorphine also lowers the risk of overdose and serious side effects, like fatal respiratory depression. In contrast, with methadone, the risk of overdose and dangerous side effects, such as respiratory failure, increases as the dosage rises.
Treatment Process
When starting medication-assisted treatment (MAT) with buprenorphine, you’ll have regular appointments with a medical provider to receive prescriptions, which you can then take at home, based on your individualized treatment plan. Compared to methadone treatment programs that require daily visits to the treatment center during the treatment’s initial phase. However, after federal and state requirements are met, a client undergoing MAT with methadone can take their medicine at home.
Moreover, under the Drug Addiction Treatment Act of 2000, qualified medical providers can prescribe buprenorphine in a variety of settings, including in hospitals, community health centers, health departments, correctional facilities, and doctor’s offices. Methadone can only be prescribed and dispensed in a structured treatment facility.
In addition, while buprenorphine and methadone both pose the risk of producing physical dependence, buprenorphine does so to much less of a degree than methadone. It is also easier to discontinue using buprenorphine than methadone.
Misuse Prevention
The naloxone contained in buprenorphine compounds, like Suboxone, reduces the chances of misuse without producing opioid effects or unwanted reactions as long as it’s taken as directed. When naloxone is taken in other ways, instant withdrawal symptoms can occur. That’s why Suboxone is so beneficial to patients. It provides the treatment benefits of naloxone without the risks. This can serve as an incentive to adhere to MAT program instructions as prescribed. Methadone, by contrast, may prevent cravings and withdrawals too, but it does not provide the same benefits of reduced risk of misuse without producing opioid effects or unwanted reactions.
The right medication for you will depend on your personal history with opioid use and several other important factors. When you explore MAT, a trained medical professional will work with you to find the treatment option that best suits your needs.
Recovery Phases of Buprenorphine Treatment
In a Medication-Assisted Treatment (MAT) program using buprenorphine, patients move through four key phases designed to help them recover from opioid use disorder.
- Induction: A medical provider will start you with a low dose, which is adjusted to alleviate withdrawal symptoms after abstaining from opioids.
- Stabilization: Patients decrease opioid misuse, allowing them to better engage in supportive therapies like counseling.
- Maintenance: continues as long as necessary, helping patients maintain stability without cravings or side effects.
- Taper: In cases where you, as the director of your treatment, feel it is time to consider options in “coming off” of the medication, your medical provider and counselor will help you develop a plan that accounts for your requested pace, safety, and maintenance of your daily well-being. When this phase begins it is different for everyone, but in most cases, it is after you have been in treatment for at least two years.
Throughout the entire MAT process, regular check-ins with healthcare providers and participation in counseling and support services are essential for lasting recovery. For more detailed information on the different phases of MAT treatment, [click here].
Who Makes a Good Candidate for Buprenorphine Treatment?
You may be a good candidate for MAT with buprenorphine if:
- A medical provider has diagnosed you with an opioid dependency or opioid use disorder.
- You are willing to adhere to all treatment protocols, including safety precautions.
- You have been cleared by a medical provider of any potential health problems that might conflict with buprenorphine use.
Buprenorphine treatment for opioid dependence may also be appropriate when a patient has medical reasons they cannot take methadone or is allergic to the medication. It may also be the better choice when methadone treatment centers and healthcare providers are not immediately or conveniently accessible to the patient.
Find Addiction Treatment at HCRC’s Buprenorphine Clinics
At HCRC, we offer patients buprenorphine-based treatment at centers throughout New England. Here, you or your loved one living with an opioid use disorder can receive OBOT in a safe, supportive, and judgment-free environment.
For those interested in methadone maintenance programs, we offer this treatment at our treatment center locations throughout Maine, New Hampshire, Connecticut, and Massachusetts as well.
