Medication-assisted treatment is a proven and effective method to overcome opioid-use disorders (OUD). Medicines used for OUD include three Food and Drug Administration approved drugs — buprenorphine, methadone, and naltrexone. This page focuses on buprenorphine, often called “bupe” affectionately by those who are prescribed it.
Buprenorphine or “bupe” is an FDA-approved medication to treat OUD. Bupe stops opioid withdrawal and has a low risk for abuse compared to other illicit opioids. It is available in tablet or film formulations which are placed under the tongue. Patients are advised not to cut, chew or swallow bupe for maximum effect.
Bupe is a partial opioid that binds to opioid receptors in the brain and reduces cravings for opioids while also preventing withdrawal symptoms. Since bupe is a partial opioid, it can not produce a greater opioid effect beyond a specific dose. This is called the “ceiling effect”. The ceiling effect means that even taking large doses of bupe will not allow a person to have so much respiratory depression that they accidentally overdose. This makes it a “safer drug” than full opioids like oxycodone, methadone, heroin, and fentanyl.
Suboxone combines bupe with naloxone, an opioid antagonist, to discourage the misuse of the medication, making it even more safe.
Buprenorphine suppresses withdrawal, restores a feeling of normalcy, and protects against overdose by blocking the full activation of receptors.
Brian Clear, MD, FASAM, Medical Director at Bicycle Health
Before taking bupe, it is important to be off opioids. If not, bupe may accelerate opioid removal from receptors in the brain, precipitating withdrawal. After a short period of opioid abstinence, usually somewhere between 8-12 hours, you can start taking bupe.
The first phase of using bupe, known as the initiation phase, can last up to 72 hours and helps effectively manage withdrawal symptoms. Following this, you'll be free of withdrawal symptoms. You can continue to use bupe as maintenance medication, temporarily or long-term.
To learn more about Bicycle Health's telemedicine approach to bupe (buprenorphine) treatment, call us at (844) 943-2514 or schedule an appointment here.