Which Forms of Buprenorphine Are Most Commonly Abused?

Which Forms of Buprenorphine Are Most Commonly Abused?

Which Forms of Buprenorphine Are Most Commonly Abused?

Which Forms of Buprenorphine Are Most Commonly Abused?Buprenorphine is an opioid medication designed to help prevent severe withdrawal symptoms in people affected by opioid dependence or addiction. The medication comes in three main forms. Although buprenorphine is substantially weaker than the average target of opioid abuse, some people still intentionally misuse it. In a study published in July 2014 in the Journal of Substance Abuse Treatment, researchers from five U.S. institutions conducted a large-scale analysis in order to determine which forms of the medication are most likely to serve as sources of opioid abuse

Opioid Dependence and Addiction

All opioid drugs and medications reach the brain through sites, called opioid receptors, located on certain nerve cells. Opioid dependence occurs when a repeated user or abuser of an opioid undergoes changes in their brain chemistry that produce a reliance on continued consumption of the drug or medication in question. Some dependent opioid users strictly follow treatment guidelines set forth by their doctors and don’t suffer any particular adverse consequences from their medication intake. However, other dependent users (especially those who take illegal opioid drugs or fail to follow their doctors’ instructions) have highly elevated risks for developing an uncontrolled opioid addiction. Symptoms common to both opioid dependence and opioid addiction include the onset of withdrawal when opioid intake falls below the brain’s expectations and a rising tolerance to the effects of any given opioid dose. Additional symptoms of opioid addiction include recurring urges for further opioid intake and the establishment of a dysfunctional daily routine centered on various aspects of opioid consumption.


Buprenorphine has been in use since the early 2000s as a treatment for people dealing with opioid dependence and addiction. When given to someone accustomed to taking strong opioid substances, the medication produces a smaller and slower drug effect. This reduced effect is sufficient to relieve the symptoms of withdrawal during treatment, but not typically large enough to encourage a shift to buprenorphine as a main target of abuse. However, some people (especially those individuals with no prior history of using stronger opioids) do target buprenorphine and either misuse their own prescriptions or seek to gain access to the medication without a prescription.

Buprenorphine comes in three forms: an under-the-tongue tablet that only contains the medication, an under-the-tongue tablet that also contains a second medication (called naloxone) that puts time limits on the drug effects of buprenorphine and an under-the-tongue, dissolvable film that contains both buprenorphine and naloxone. Naloxone is an anti-opioid substance specifically added to buprenorphine as a deterrent to people targeting the opioid medication for abuse.

Which Forms Are Most Abused?

In the study published in the Journal of Substance Abuse Treatment, researchers from the Rocky Mountain Poison and Drug Center, Washington University in St. Louis and three other institutions used information collected from a number of well-regarded drug and medication surveillance programs to determine which of the three forms of buprenorphine are most likely to function as targets for opioid abuse. The programs under consideration included the Survey of Key Informants’ Patients (SKIP) project, the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) project, the College Survey Programs, the Poison Center Program and the Opioid Treatment Program. Each of these programs relies on its own specific methods to identify and quantify substance abuse. The gathered information covered the year 2012.

After analyzing the collected data, the researchers found that the surveillance programs under consideration produce varying results when it comes to identifying the most commonly abused form of buprenorphine. Several programs—including the College Survey Programs, SKIP and the Opioid Treatment Program—identify buprenorphine-only, under-the-tongue tablets as the most common targets of abuse. Conversely, the Poison Center Program identifies combined buprenorphine/naloxone under-the-tongue tablets as the most common targets of abuse. The Poison Center Program also identifies buprenorphine/naloxone tablets as the form of buprenorphine most likely to get diverted from sanctioned channels of distribution.

The study’s authors note that all of the surveillance programs under consideration agree that buprenorphine/naloxone film is the form of the medication least likely to serve as a target for drug abuse. When they looked at the potential for geographic differences in national patterns of buprenorphine abuse, the authors could find no indication that one region or another has higher or lower rates of misuse for any particular form of the medication.

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