Top Three Myths about Buprenorphine Busted
What most doctors think they know about buprenorphine just isn’t so. Unfortunately, these myths about this unique chemical may hurt you. These myths about buprenorphine prevent its use for the treatment of pain, prevent its use in those that cannot be opioid-free for a period of time, and prevent its use during the time of surgery. It’s about time we bust some of these myths about buprenorphine so that more people can take advantage of the benefits of buprenorphine for the treatment of pain and opioid dependency.
Myth #1: Buprenorphine is Not a Good Pain Reliever
Nothing really could be further from the truth than this myth. When compared head-to-head with morphine for the treatment of post-operative pain, buprenorphine was as good if not better at relieving pain. And for the treatment of pain, there is nothing “partial” about it because it really is a full agonist that fully activates pain relieving receptors. Buprenorphine really needs to be viewed as being effective for all types of pain. (1)
Myth #2: Buprenorphine Can Only be Started After An Opioid-Free Period
For years, doctors have been taught that in order to start someone on buprenorphine, a patient must stop using the current opioid for 24 to 48 hours. This has created a barrier to access for many individuals afraid of going without an opioid for that long or unable to risk experiencing any type of withdrawal symptoms. In a recent paper describing three cases, clinicians have describe a new way to “induce” a person onto sublingual buprenorphine by using transdermal buprenorphine as a “bridge”. Absolutely genius, by tackling this myth and busting it open, doctors now have more options for treating people, like pregnant women, with buprenorphine. (2)
Myth #3: Buprenorphine Blocks other Opioids
Because many doctors believe this myth to be true, most think that patients that plan to have surgery cannot be using buprenorphine because it would interfere with the ability to control post-operative pain. Researchers have debunked this myth too by proving that the pre-operative administration of buprenorphine did not interfere with ability to control pain with other opioids after surgery. In fact, buprenorphine improved pain control. Thus, people using buprenorphine do not have to stop using buprenorphine if they are going to have surgery. (3)
Buprenorphine is poorly understood by doctors and patient alike because these myths have clouded clinical judgment for years. The fact is that buprenorphine is a really good pain reliever that can be safely started without stopping other opioids. Additionally, buprenorphine is a really good pain reliever that can be continued even through surgery.
- Raffa, RB; et al; The Clinical Analgesic Efficacy of Buprenorphine; Journal of Clinical Pharmacology and Therpeutics; 2014 Dec: 39(6) 577-83
- Kornfeld, H; et al; Transdermal Buprenorphine, Opioid Rotation to Sublingual Buprenorphine, and the Avoidance of Precipitated Withdrawal: a review of literature and demonstration of three chronic pain patients treated with Butrans; American Journal of Therapeutics; 2015 May-June: 22(3): 199-205
- Kornfeld, H; et al; Effectiveness of Full Agonist Opioids in Patients Stabilized on Buprenorphine undergoing Major Surgery: a case report; American Journal of Therapeutics; 2010: Sept-Oct; 17(5) 523-8
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.