Buprenorphine is the generic name for a medication to treat both chronic pain and opioid use disorder (OUD). It comes in multiple forms. Suboxone, which is the most common form, is a sublingual film. However, it also comes in a weekly transdermal patch called "Butrans".
Butrans is currently only approved to manage chronic pain and is not usually prescribed as a treatment for OUD. While some medical studies suggest transdermal patches like Butrans are excellent MAT, the FDA has not yet approved these at this point - specifically for the treatment of OUD..
Some people may benefit from Sublocade, a form of Suboxone that is injected under the skin once per month and releases slowly into the bloodstream. Still,traditional Suboxone, which is taken sublingually, is the most accessible and frequently prescribed form of buprenorphine.
Suboxone is one of the most important medication options for people overcoming opioid use disorder (OUD).
This prescription Medication for Addiction Treatment (MAT) is a film strip placed underneath the tongue so it can quickly dissolve into the bloodstream. It is taken once per day. It can be prescribed and supervised through a general physician, making it an accessible approach to addiction treatment.
The active ingredient in Suboxone is buprenorphine, a partial opioid agonist that binds to the brain’s opioid receptors without triggering euphoria. For people overcoming OUD, buprenorphine eases withdrawal symptoms and cravings, making it easier to remain abstinent.
The medication is relatively easy to take, but some people struggle to remember to take it once per day or perhaps dislike the taste. Extended-release formulas of buprenorphine, like subdermal implants or Sublocade, could work better for those who prefer not to have to take a daily mediation..
An extended-release buprenorphine patch — under the brand name Butrans — was approved by the US Food and Drug Administration (FDA) in 2010 for chronic pain. Buprenorphine patches have not yet been approved for MAT by the FDA. However, some providers may use them off-label as a treatment for OUD in appropriate patients.
Butrans is the brand name for a transdermal patch changed once per week, which administers a consistent buprenorphine dose over seven days. Although buprenorphine is often used as MAT for people overcoming opioid use disorder, Butrans has only been approved by the FDA to treat chronic pain. However, some providers have experimented with using Butrans off-label to treat OUD in patients who struggle to take a daily sublingual film like Suboxone.
The Butrans patch is manufactured by Purdue Pharmaceuticals, who developed this treatment for people who need pain management 24/7 and for whom other opioid treatment options were inadequate. Butrans is a Schedule III medication, meaning there is some addictive potential for people who are opioid-naïve, but it is less potent than other opioid medications like oxycodone or hydrocodone, which are Schedule II.
Medical research into applying a buprenorphine patch as MAT is just beginning. Prior to the FDA approval of Butrans, a study on buprenorphine transdermal patches in 2007 reported that buprenorphine patches appeared to be well-tolerated among those overcoming OUD.
The study examined reactions of nine volunteers who were diagnosed as opioid dependent, who entered a 10-day opioid withdrawal program. They received patches that delivered 1.9 milligrams of buprenorphine per day and changed their patches every three days. About half the participants reported a reduction in withdrawal symptoms when they used the patches.
A more recent narrative review of buprenorphine patch studies, published in 2019, found that there is potential to use transdermal patches in opioid-dependent individuals to help them overcome addiction.
Side effects of buprenorphine patches like Butrans include the following:
It is important to tell your doctor if you experience side effects.
Avoid other opioid medications to treat pain while using the patch. Inform your physician if you need to adjust other medical treatments that might interact with buprenorphine, and avoid drinking alcohol while on the patch.
If you have chronic pain, Butrans is available by prescription at most pharmacies. Your insurance may cover part of the cost, but it may not cover the entire cost of your treatment.
The medication can be expensive, with some online sources reporting costs ranging from $90 to $150. You cannot legally get Butrans without a prescription.
If you are overcoming an OUD, seek treatment with medical professionals who provide MAT. Suboxone is the current standard for MAT. Other, newer options include Sublocade, which is an extended-release, subdermal injection.
Most insurance plans cover addiction treatment services, so the cost of Suboxone may be covered by your health insurance. Talk to your provider about the specifics of your coverage.