02 Jan Is Buprenorphine Abuse Increasing?
Buprenorphine is the generic name of a sublingual (under-the-tongue) medication that doctors in the U.S. can prescribe for people receiving treatment for an opioid addiction. Since this medication is also an opioid substance, it can potentially function as a target of substance abuse. In a study published in 2014 in the journal Drug and Alcohol Dependence, researchers from two American universities used a large-scale project to help determine if the rate of buprenorphine abuse is increasing. These researchers also investigated the reasons any given individual would choose the medication as an abuse target.
Despite its standing as an opioid substance, buprenorphine lacks the mind-altering power of commonly abused opioids such as heroin, oxycodone or hydrocodone. In addition, the medication takes a longer amount of time to produce its most intense effects. Together, these moderating characteristics make buprenorphine useful as a replacement for stronger opioids in people receiving treatment for an opioid addiction. When given a limited amount of the medication, these individuals can successfully avoid the worst effects of opioid withdrawal while substantially increasing their odds of getting their drug use under control and remaining in treatment. Some people receive a formulation of the medication that contains only buprenorphine as an active ingredient. However, others receive a formulation that also contains naloxone, an anti-opioid medication that cuts off the drug effects of buprenorphine after a fairly brief amount of time. Naloxone is added specifically to reduce the chances that any given buprenorphine recipient will start misusing the medication.
Despite the relatively modest opioid effect of buprenorphine and the safeguard provided by the addition of naloxone, some people still take the medication in ways not intended by their prescribing physicians or take the medication without having a legitimate prescription. Because they’re used to stronger opioids, people receiving buprenorphine as part of opioid addiction treatment are usually viewed as relatively unlikely to fall into a pattern of buprenorphine abuse, although abuse among these individuals remains a possibility. The risks are typically considered much higher in people who have no prior history of using strong opioids and therefore experience a significant increase in their pleasure levels when they take the medication. If a person who’s addicted to opioids injects a buprenorphine/naloxone combination, they can potentially trigger the onset of opioid withdrawal by intensifying the relative anti-opioid effect of naloxone.
Is Abuse Increasing?
In the study published in Drug and Alcohol Dependence, researchers from Washington University in St. Louis and Nova Southeastern University used a combination of methods to help determine if the rate of buprenorphine abuse is rising in the U.S. Part of the information these researchers used came from surveys administered to a total of 10,568 people receiving treatment for opioid addiction throughout America. In addition, they gathered information from a subgroup of 208 people in treatment who took part in a more in-depth interview process. The researchers also gathered information on the subject from officials working for over two dozen law enforcement agencies located throughout the country. The project covered the rate of buprenorphine abuse over a period of five years (2008 to 2013) and explored the underlying motivations for participating in buprenorphine abuse.
After reviewing the data collected from their diverse sources, the researchers concluded that the rate of buprenorphine abuse did increase sharply during the timeframe under consideration. Perhaps surprisingly, the steepest rise occurred among people who use the powerful street opioid heroin. When they explored the reasons for the prolonged spike in abuse rates, the researchers concluded that the main factor is the many ways in which abusers can take advantage of the medication. These ways include using buprenorphine as a makeshift substitute for less available opioid substances, using the medication to ease the impact of physical pain, using buprenorphine strictly as a source for getting “high,” using the medication to limit the impact of opioid withdrawal, using buprenorphine as self-treatment for mental health problems and using the medication as part of an unsupervised attempt to break the grips of opioid addiction.
The study’s authors note that getting “high” is not a common reason for beginning or maintaining a pattern of buprenorphine abuse. When used/abused to decrease opioid withdrawal symptoms or as part of an attempt at unsupervised addiction recovery, the medication is often viewed as a superior alternative to the opioid medication methadone.
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