Suboxone contains two ingredients: buprenorphine and naloxone. Buprenorphine can come in many forms, including strips, tablets, injections, implants and patches.
Companies have developed a buprenorphine patch sold under the brand name Butrans. This medication is designed to treat chronic pain, but not addiction.
If oral medications aren’t right for your recovery plan, you have choices. You can use an injectable form of Suboxone, but most people find that tablets or films work better.
What Is Butrans?
An extended-release buprenorphine patch sold under the brand name Butrans was approved by the U.S. Food and Drug Administration (FDA) in 2010 for chronic pain.
The Butrans patch is manufactured by Purdue Pharmaceuticals. They developed this treatment for people who need pain management 24/7 and for whom other opioid treatment options are inadequate.
Butrans is a Schedule III medication, meaning there is some addictive potential for opioid-naïve people. It is less potent than other opioid medications like oxycodone or hydrocodone, which are Schedule II.
How Is It Used?
Butrans patches are changed once per week, administering a consistent buprenorphine dose over seven days.
People can apply patches to their arms, chest, or upper back. Every time they switch patches, they must pick a new site. The patches work best when they’re applied to hairless skin.
Not Yet Approved as an Addiction Treatment
Buprenorphine patches like Butrans are FDA-approved for pain relief only. They’re designed for people who need around-the-clock care for significant pain that doesn’t respond to other types of care. At this point, patches like Butrans aren’t FDA-approved for Medication for Addiction Treatment (MAT) programs.
Medical research into buprenorphine patch as MAT is just beginning. Before 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 opioid use disorder (OUD).
The study examined the reactions of nine volunteers diagnosed as opioid dependent who entered a 10-day opioid withdrawal (detoxification) program. They received patches that delivered 1.9 mg of buprenorphine daily and changed their patches every three days. About half the participants reported reduced 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 SUD.
FDA-approved medications can sometimes be used in unusual ways. From the FDA’s perspective, doctors can use approved drugs for an unapproved use if they deem it appropriate. This “off-label” use is totally legal, but it does come with some risks. Experts may not have all of the data you expect about how much to take and what side effects to expect.
Some doctors use buprenorphine patches in their MAT programs on an off-label basis. Others lean on the MAT solutions that are FDA-approved for OUD, such as Suboxone.
Effectiveness of Buprenorphine Patches for Chronic Pain
Buprenorphine patches deliver a small amount of medication for an extended period. Research suggests that they are a safe and effective way to treat chronic pain problems.
Studies suggest that buprenorphine patches come with fewer side effects than sublingual forms of buprenorphine, and they’re harder to misuse.
Additional research suggests that people with chronic pain have an improved quality of life when using patches compared to when taking oral opioids or tramadol.
Long-term studies suggest that using patches can improve quality of life, ease insomnia and reduce pain scores in people with severe chronic pain.
Buprenorphine Patches vs. Other Forms of Pain Treatment
Buprenorphine is a versatile medication that comes in several formats for people experiencing chronic pain. This comparison table can help you understand how each version works.[3,8,9]
|How Often Administered?
|Where Is It Administered?
|Under the tongue
|Once or twice daily
|Inside the cheek
|Every seven days
|Arms, chest or back
|5-10 mcg per hour
Side Effects From Using a Buprenorphine Patch
Side effects of buprenorphine patches like Butrans are similar to the side effects of Suboxone and include the following:
- Trouble falling and staying asleep
- Dry mouth
- Stomach pain
- Skin irritation, itching, and swelling in the area where the patch is placed
- Other itching or hives as an allergic reaction
- Chest pain
- Symptoms of overdose, including trouble breathing and changes in heartbeat
It is important to tell your doctor if you experience side effects.
MAT for Addiction Care
If you are overcoming an OUD, seek treatment with medical professionals who provide MAT.
Suboxone is the current standard for MAT. This prescription medication is placed inside the mouth, dissolving quickly into the bloodstream. It is taken once per day. It can be prescribed and supervised by a general physician, making it an accessible approach to addiction treatment.
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 take daily medication.
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.
By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Butrans Drug Approval Package. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/021306_butrans_toc.cfm. September 2011. Accessed January 2023.
- Butrans Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/021306s015s019lbl.pdf. June 2014. Accessed January 2023.
- Buprenorphine Transdermal Patch. U.S. National Library of Medicine. https://medlineplus.gov/druginfo/meds/a613042.html#how. December 2022. Accessed January 2023.
- Evaluation of a Transdermal Buprenorphine Formulation in Opioid Detoxification. Addiction. https://pubmed.ncbi.nlm.nih.gov/17854341/. October 2007. Accessed January 2023.
- Transdermal Buprenorphine Patch: Potential for Role in Management of Opioid Dependence. Asian Journal of Psychiatry. https://www.sciencedirect.com/science/article/abs/pii/S1876201818310761?via%3Dihub. February 2019. Accessed January 2023.
- Buprenorphine for Chronic Pain: A Safer Alternative to Traditional Opioids. Health Psychology Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8567798/. August 2021. Accessed January 2024.
- Long-Term Maintenance of Improvements in Patient-Reported Functioning, Quality of Life, and Pain Outcomes for Moderate to Severe Chronic Pain Patients Receiving Continuous Treatment of Butrans Transdermal System. The Journal of Pain. https://www.jpain.org/article/S1526-5900(13)00695-0/fulltext. April 2013. Accessed January 2024.
- Belbuca Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/207932s000lbl.pdf. October 2015. Accessed January 2024.
- Subutex Prescribing Information. U.S. Food and Drug Administration. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/020732s018lbl.pdf. February 2018. Accessed January 2024.
- Understanding Unapproved Use of Drugs “Off Label.” U.S. Food and Drug Administration. https://www.fda.gov/patients/learn-about-expanded-access-and-other-treatment-options/understanding-unapproved-use-approved-drugs-label. February 2018. Accessed January 2024.
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