Buprenorphine: The New Treatment for Opiate Dependence

The treatment of opiate dependence has been particularly unsuccessful over the years. There are more and more people abusing opiate-based pain medications. Oxycontin and Vicodin are the most abused prescription medications on the market these days. It has become clear that once dependence is established, opiate addicts are often not the easiest to manage. Thus began the search for medications and strategies to assist the opiate addict in loosening the bonds of addiction.

One solution has been the reorientation of drug treatment toward better management of the natural course of opiate addiction through the use of safer maintenance drugs. This is a harm reduction model that views the goal of opiate treatment as interrupting both the pathological social processes that typically accompany heavy use of opiates, and eliminating the damaging consequences of an endless cycle of withdrawal and drug craving.

The idea behind this medically prescribed maintenance treatment model is to interrupt the progressively worsening processes of opiate addiction by permitting the opiate-dependent person to end reliance on illicit drug markets. Basically, treatment focuses on replacing more dangerous and often illegal drugs with safer, legal ones. This model can effectively neutralize the endless cycle of craving and avoidance of withdrawal. Maintenance can permit opiate-addicted persons to get back on track with their lives even though they haven’t been ‘cured’ of their dependence on opiates, for very real and necessary pain management.

Research has shown that opiate-dependent patients do not respond as well to traditional treatment approaches. Various medications, such as Methadone and Naltrexone, have been tried with some success, yet they have not proven to be universally successful. Methadone clinics can only treat a fraction of the opiate addicted clientele and are not often structured to provide extensive counseling. This has left many opiate addicts without treatment and continuing to use despite adverse consequences.

With the FDA approval of Buprenorphine-based medications, more opiate-dependent clients gain access to treatment. Certified physicians are able to prescribe the medications in their offices and clinics. This is to be combined with the physicians referring patients to trained therapists for immediate and long-term relapse prevention counseling as part of a whole recovery plan.

Buprenorphine, as it binds to the opiate receptors, both blocks other opiates from binding and diminishes the strength and frequency of physiological opiate cravings. Often those in early opiate recovery are confronted with unexpected strong cravings that can be repeatedly triggered by simple circumstances, such as a small painful injury, an emotion, or even the time of day one used to be habitually conditioned to use drugs. Clients utilizing Buprenorphine opiate replacement therapy as part of an overall treatment plan, including counseling, state that they experience fewer and less intense cravings. This then allows the treatment process to work effectively as the client rapidly develops and practices relapse prevention skills and makes lifestyle changes.

The use of Buprenorphine-based medications in private physician’s offices is a revolutionary development in the treatment of opiate dependence and one we should wholeheartedly embrace.