Does Buprenorphine Really ‘Save Lives’?

Legal disclaimer: Nothing in this post is meant to be construed as medical advice. I am not a physician or pharmacist. Discuss any medications, changes, or questions you might have with your medical provider. Do not suddenly stop any medication unless under the direct guidance of a medical provider.

Today was a weird day. What began with some light historic-ecclesiastical reading and plans to write a piece about a specific trend in feminism in antique literature, turned instead into a Twitter brawl in which I repeatedly questioned doctors and pharmacists on a certain status quo, and received 5th-grade-style memes of Homer Simpson in response. What was the cause? Buprenorphine.

More popularly known as Suboxone or Subutex, buprenorphine (“bupe” for short) has been touted in recent years as “the” drug of choice to treat opioid dependence disorders (formerly known plainly as “addiction,” for politically-incorrect and insensitive jerks like me, or so I was told).

Although my concerns about the safety and efficacy of buprenorphine became quickly misinterpreted as a war on drug addicts (or whatever the PC term is now), I ended up spending the day reading through study after study (see below for a list), but was hopelessly ganged up on by dozens of angry and less-than compassionate “professionals” who took the time to point out I must know nothing about the subject because I also “make jewelry.”

They insisted I could not read scientific or medical literature although such things are written in English and I am blessed to have access to ‘foreign’ objects like the internet and dictionaries to look up any unfamiliar terms, and in short, I had it all wrong, and my misinformation would inevitably lead to the untimely end of numerous, unnamed individuals. I just needed “to trust my doctors,” insisted one.

They had already read all the studies and charts I supplied, which is why they needn’t bother to look at the ones I provided and actually answer my questions. I hadn’t been privy to that much gas-lighting since the most recent family holiday.

I guess I touched a nerve.


What is Buprenorphine?

Buprenorphine is most commonly used in the US to treat opioid addiction. The idea is to transition people off heroin (and dirty needles, and other unhealthy practices associated with street drug addiction) and/or illicit painkillers. In much, much smaller doses (micrograms vs. milligrams), it is used to treat severe pain. Bupe is an opioid, and can cause addiction in and of itself.

all opioids are addictive

Money, Money by the Pound!

There have been many back-end, sly marketing techniques, going on for at least a decade by the makers of bupe, Reckitt-Benckiser/Indivior, recently accused of attempting to artificially prolong the patent on Suboxone.

There is a ton of money to be made by doctors who prescribe it (average $300 for first appointments, $150 or more for subsequent/monthly appointments, and whatever can be earned in lab and pharmaceutical kickbacks).

Bupe, in the form of Suboxone, costs an average of $151-518 for just 30 days of sublingual filmstrips for the uninsured, depending on dosage, and about $180-720 for 30 days of sublingual tablets, depending on dosage, up to 3x/day, although an original study of the drug, paid for in part by Reckitt-Benckiser, show the drug can last up to 3 days before needing a new dose. This was, in fact, a huge selling point of bupe, that people would not need to come daily to Suboxone clinics for the medication.

Patients on bupe can successfully go for 2-3 days on just one dose, reducing the need for daily clinic visits, and/or “reducing the need for take-home medications [which] decreases the possibility of illicit diversion and abuse of opioid dependence pharmacotherapies (Section 6)”


No Such Thing as Chronic Pain?

butrans patch dosing

That Old-Time Naloxone is Good Enough for Me

“The doses of naloxone that precipitated withdrawal [in patients given 8mg of sublingual and 3 and 10mg doses of BPN/day]…were approx. 10 times greater than those that precipitated withdrawal in patients maintained with 30mg oral methadone” (Section 3.2.3).


The One “Good” Opioid in the Epidemic?

Why Aren’t People Getting Clean with Bupe?


99 Problems, and the Studies are 1, 2, 3…

This is Not Treatment

recidvism rate for OD

-Source

Does Buprenorphine Really Save Lives?

“Buprenorphine is now more popular than cocaine, ecstasy, and heroin in some European countries. It is easy to obtain, currently quite fashionable, popular with opioid aficionados, and apparently associated with a quite pleasurable high when injected or snorted.

I would not be surprised to see more BPN issues in the ED, given the rise in its popularity, its increasing availability, and its perceived wide margin of safety. One might be confused by an opioid toxidrome with a negative drug screen unless the drug has been identified by history.” –Source


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Sources Cited:

https://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2016/10/11/public-policy-statement-on-morphine-equivalent-units-morphine-milligram-equivalents

https://www.nejm.org/doi/full/10.1056/NEJMp1802741?page=4#article_comments

https://www.kolmac.com/2015/12/qa-dr-andrew-kolodny-chief-medical-officer-phoenix-house/

https://www.ncbi.nlm.nih.gov/pubmed/12738347

https://www.sciencedirect.com/science/article/pii/S0376871603000565?via%3Dihub

https://www.drugs.com/dosage/butrans-patch.html

https://www.drugs.com/sfx/butrans-side-effects.html

https://www.miamiherald.com/news/nation-world/national/article171182767.html

https://www.sciencedirect.com/science/article/pii/S0140673603126001

https://www.health.ny.gov/publications/9555/

https://journals.lww.com/em-news/Fulltext/2009/01000/Buprenorphine__Toxicity_and_Overdose.6.aspx

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment


More Sources:

https://www.bloomberg.com/news/features/2017-11-06/how-doctors-are-getting-rich-on-urine-tests-for-opioid-patients

https://www.npr.org/2017/06/19/533481621/how-an-opioid-treatment-could-be-contributing-to-the-problem

https://www.drugs.com/price-guide/suboxone

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment

https://www.crchealth.com/addiction/heroin-addiction-treatment/heroin-detox/buprenorphine-suboxone-vs/

https://www.pharmacytimes.com/contributor/jeffrey-fudin/2018/01/opioid-agonists-partial-agonists-antagonists-oh-my

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258993/

https://www.therecoveryvillage.com/naltrexone-addiction/side-effects/#gref

https://www.naabt.org/faq_answers.cfm?ID=64

https://www.sciencedirect.com/science/article/pii/S0007091217540817

https://jamanetwork.com/journals/jama/fullarticle/2456156

Published by Loura Shares A Story

Loura Lawrence is a tireless, creative entrepreneur specializing in media, communications, and the arts. She holds a Liberal Arts degree in English with a background in photojournalism, and is passionate about education, public policy reform, and women's issues. www.RamblingSoapbox.com

6 thoughts on “Does Buprenorphine Really ‘Save Lives’?

  1. Thank you for printing what pain patients have known for years. Ms Reynolds lot her life in an oddly timed plane crash. Known for her Advocacy work for treatment of pain patients.

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  2. I’ve been talking about the serious problems with Buprenophine for a few yesfs. It was a nurses who had worked at a state prison I’d been dating who told me how it has become popular in prisons as a standard drug panel will not detect it . Much more expensive as in $_2,000 a inmate , GC MS tests specifically run for it . Convicts quickly found out and as it is a flim it is very easily smuggled in to correctional facilities. The pills less expensive Buprenophine pills minus the next to useless Naloxone are also easily smuggled in via corrupt guards who think it’s no big deal as Buprenophine has been hyped as anti addiction drug or bizarrely a opioid blocker ! Who do you think might be behind those lies . My guess are the the Rummler Foundation and another group who is invoked with our own version of Joesf Mangle , Andrew Kolodny and his fanatical friends in PROP . Who are involved in the medically assisted addiction treatment industry . Which picked Buprenophine in particular the more expensive Suboxone over much less expensive Methadone. Which is also a effective and safe when used for brief periods . Though Methadone does not produce the high . It also has some effect on neuralgia. Oh wait we can’t have pain relife that’s addiction! (Sarcasm alert) Buprenophine also is known to inhibit the induction of anesthesia. Causing awareness die mg surgery a horrifying experience that is known to cause PTSD and obviously make a patient less willing to have surgery . Good job PROP ! Buprenophine is a schedule three drug interestingly. Addicts can get three refills before seeing the physician for a new R X .While Hydrocodone and oxycodone combination meds are now schedule 2 how convenient for those addiction treatment facilities or doctors . They can easily take in $ 500,000 or more just by prescribing one Drug . Unlike other opioid medication Buprenophine builds up a rapid dependency and the high is described as a combination of heroin and Ecstasy ! Great we are giving addicts a free high . As the latest bill to fight the opioid hysteria has funding to give addicts Buprenophine if they cannot afford it ! Why not free insulin? Free anti psychotic medication . I’m sure many with a psychotic disorder struggle to find a good paying job or some cannot work a full time job due to their disorders.Why can’t those of us who deal with PTSD after seeing combat or were injured while working in dangerous conditions get free benzodiazepines ? After all most of did not choose to be injured . The mentally ill did not choose to be mentally ill . Diabetics do not choose to be diabetics even if they acquire type 2_diabetes . Those with arthritis did not choose it and in so!e see a cannot get selfie from excruciating pain . Buprenophine does nothing and was not approved as a pain reliever as it is not as effective as morphine. It might bind much more tightly to Mu receptors . That is only one part of the medications pain reliving effects . If you want potent pain relief Fentanyl is extremely effective and safer that Buprenophine . The patch is harder to abuse and the thin matrix is al!most impossible to miscues unless you have a death wish .

    Addicts have discovered how to separate the Naloxone from Buprenophine in Suboxone . Not that it is difficult any one who can read a basic chemistry book or article on organic chemistry can do it with ite!s you can buy at ho!e depot was mart and Lowe’s ! Maybe a garden supply to get more accurate measurements .
    Buprenophine is very dangerous and difficult to taper and withdraw from . As it also binds to NMDA receptors and is highly lipophollic it is stored in fat cells which allow it to remain in the body longer. Unlike all but methadone it also has a very long halflife making withdrawal living hell . We do not know all the effects of tapering or withdrawal from Buprenophine .
    On a interesting and ironic note Buprenophine is synthesized from thebian the same alkaloid oxycodone and oxymorphone are derived from . Both are safer and more effective than Buprenophine . Opana was pulled from the market though the generic extended release versions are still available . Though it works best IV .
    Methadone was never given a fair chance and unlike Buprenophine which Reckitt Becnkiser and Indivor with help from lobbying and the fact DHHS and NIDA and a few senators and representatives had been lobbying for the lax laws to prescribe to addicts . Its disgusting really .
    If us pain patients and the so!e very brave doctors a long with others Josh Bloom at ASCH and people like myself who are either physicians , pharmacists , pharmacologists , even addiction counselors who must stay anonymous or lose our jobs . Another way PROP and Kolodny have silenced any opposition or those who can show them to be frauds and self interested liars pushing Buprenophine . They claim no financial interest or ties to Reckitt Becnkiser or Indivor A long with Amphstar which makes Naloxone and jacked the price over 3,000 percent ! The hall are involved in the addiction treatment industry that pushes MAT and I believe Buprenophine is the drug of choice at the troubled Phoenix House . Have heard they have forced it on cocaine and methamphetamine abusers . Now that makes no sense if they are supposed to be treating opioid addiction .
    I’m sure there’s is !ore just not enough time to dig . Also one needs a life beyond debunking an d exposing Kolodny and PROP a long with the CD C and others for the frauds and hypocritical sadistic evil criminals they are preying on those who cannot fight back a persistent to rehab,can’t refuse Buprenophine and pain patients and pain management doctors do not yet have a lobby group perhaps we need to h keep shoving fats and reality into the media and exposing the opioid hysteria for the fabricated crisis it is . I always ask why are addicts more important and valuable than innocent people who did all the right things and got injured orchards painful medical condition or syndrome?

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  3. Great article. Thank you for writing it! I feel obligated to point out, however, that you have consistently misspelled buprenorphine (you left out the “r” after “bup”. I’d hate to see your work devalued over a simple error in spelling a made up drug name. Thanks again!

    Liked by 1 person

    1. Thank you for pointing that out! I worked all night it, and was in such a rush to get it out, I completely missed the title misspelling through my bleary eyes. 🙂

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