Buprenorphine Treatment

How Does Office-Based Buprenorphine Treatment Differ From Methadone Treatment?

Buprenorphine and methadone provide different treatment experiences. The right medication for you or your loved one depends on personal experience with opioids and a variety of other factors. A trained medical professional will work with the patient to decide on the best option. Some of the key differences between the two medications include:

• Receptor activation: Buprenorphine is a partial opioid agonist. That means it activates the brain’s opioid receptors, but not to the extent of a full agonist. As a full agonist, methadone activates the receptors to the same degree as illicit opioids. Both treatments relieve withdrawal symptoms through these interactions with the brain. When taken as directed by a physician, they fulfill the brain’s need for opioids without exposure to the risks of using illicit opioids.

• “Ceiling effect”: Increasing a methadone dose enhances its effects, but it also raises the risk of side effects. Buprenorphine and buprenorphine compounds have a “ceiling effect”, which limits their ability to make someone “high”. At a certain point, taking additional medication or increasing the dose does not increase its effects. This ceiling effect also reduces side effects and the risk of overdose.

• Misuse prevention: Buprenorphine compounds such as Suboxone® contain naloxone. The manufacturer adds this medicine to decrease the likelihood of misuse. Naloxone causes no opioid effect and has no negative reaction when taken under the tongue as prescribed. However, if it is used in other ways, it can lead to instant withdrawal. This consequence of misuse is one of the benefits of Suboxone® to the patient. It provides individuals in recovery with an incentive to only participate in MAT as prescribed by their care provider.Methadone’s effectiveness as a deterrent comes primarily from its use in preventing withdrawals and cravings, but it does not contain naloxone.

• Treatment process: A patient undergoing medication-assisted treatment with buprenorphine has regular appointments. They receive a prescription for buprenorphine treatment and take the medication at home. Methadone programs require the patient to make daily visits during the initial phase of treatment. A methadone patient may take their medicine home after they meet federal and state requirements.

What Happens During Medication-Assisted Treatment With Buprenorphine?

A patient enrolled in a MAT program progresses through different stages of recovery. MAT programs such as OBOT with buprenorphine consist of four phases:

1. Induction phase: The patient has an intake assessment where the doctor determines the right starting dose. As the doctor and patient work together, they search for a comfortable dose that relieves cravings and withdrawal. During this phase, the doctor will increase the buprenorphine dose until they achieve the intended results.
2. Stabilization phase: Once the patient discovers the right dose, they move on to the stabilization phase. Fewer physical symptoms let the patient focus on their addiction’s underlying causes. They can dedicate themselves to counseling and other support services. At this point in treatment, many patients at HCRC are able to stop using illicit opioids.
3. Maintenance phase: A patient enters the maintenance phase when they can keep up with treatment. They take a suitable dose of buprenorphine and attend their program services as directed. The patient can regain the life they had before addiction, but this time they have better coping mechanisms and a support system.
4. Taper phase: Most patients take at least two years to reach the taper phase after starting the maintenance phase. During the taper phase, the doctor and patient work to lower the buprenorphine dose. They finish the taper phase when the patient no longer takes the medicine, and the patient completes treatment.