The United States is facing an opioid crisis that has never been seen in the history of the country. An unprecedented 116 people die a day from opioid-related drug overdoses. This staggering statistic reflects something even more disturbing in that Americans are now more likely to die from an opioid overdose than in a car accident.
The National Safety Council calculates that dying from an opiate overdose has increased to 1 in 96, which surpasses the odds of dying in a car accident, at 1 in 103. It’s also higher than the odds of dying from a fall, a gun assault, a pedestrian accident, or drowning. The opioid crisis remains an abstract issue from many because they don’t believe it will happen to them.
The only two leaders in death continue to be heart disease and cancer, but overdose deaths continue to rise statistically. The question we must ask ourselves is, how did we get here?
From 1999 to 2017, more than 700,000 people succumbed to an overdose because of their addiction to opioids, and 70,200 drug deaths in 2017 involved an opioid.
The opioid crisis can be outlined in three distinct waves. The first wave began in the 1990s with the increase of prescription pills (natural and synthetic) when pharmaceutical representatives assured doctors their products were not harmful or addictive. This led to doctors prescribing the medications freely with no consequences to their actions. Then it started to get much worse.
The second wave came in 2010 with the rapid increase in overdoses involving heroin. By this point, the opioid epidemic was well-documented, and the government was aware of what was happening. At this point, more procedures were being implemented to curb those getting drugs from doctors, and what happened was these same people, unable to get their drugs, turned to the streets for heroin.
The heroin supply was cheap and plentiful, and there were better alternatives to the more expensive drugs like OxyContin. The third wave was in 2013 when synthetic opioids like fentanyl hit the street. A much cheaper and stronger alternative to heroin, it has made its name in the drug community.
Today, we have drugs like buprenorphine, which is intended to help treat drug users who are in recovery from substance abuse and addiction. An unintended consequence, however, is that addiction to buprenorphine is emerging.
When prescription medication is used correctly, it can provide relief. It is used similarly to methadone or Suboxone as a means to treat cravings from stronger drugs like heroin or fentanyl, but it produces a calming opioid effect that users target.
Buprenorphine is an opioid medication used to treat opiate addiction in a physician’s office or during treatment. It can also be dispensed for take-home use by prescription. Buprenorphine is different from other opioids in that it is a partial opioid agonist, which means it results in less euphoria, less potential for misuse, a ceiling on opioid effects, and mild withdrawal symptoms. It is intended to treat symptoms of opiate withdrawal, decrease cravings of opioids, reduce illicit opioid use, and help clients stay in treatment.
Buprenorphine is a semi-synthetic opioid derived from thebaine, an alkaloid of the poppy plant. It is a partial opioid antagonist that can produce opioid effects such as euphoria and respiratory depression. At low doses, it provides sufficient agonist effects to enable opioid-addicted individuals to stop misusing opioids without experiencing withdrawal symptoms. The agonist effects increase linearly with increasing doses of the drug until it reaches a plateau and no longer increases as the dosage increases.
The drug has the potential to block the effects of full opioid antagonists and can precipitate withdrawal symptoms. This is the result of the high affinity it has to the opioid receptors. It had been a worthy adversary in the fight against opioid addiction for quite some time, but it has become an easy target for abuse.
Thirty-one percent of those interviewed said it was easier to find buprenorphine than to get OxyContin or methadone on the street. The problem with the drug, though, is that in some cases, it can be like trading one addiction for another.
Due to buprenorphine being a drug that is used to treat opioid addiction, it may be difficult to spot the warning signs. The symptoms of abuse can range from mild to severe, and it is essential to understand the signs someone may be exhibiting. While the individual is transitioning from a state where they were using potent opioids like heroin into sobriety, taking buprenorphine may seem reasonable, but over time, use can spiral and develop into another full-blown addiction to the drug. There are signs and symptoms to look out for if you suspect that either you or a loved one has lost their control.
There are several potential effects from the abuse of buprenorphine that include a person’s self-esteem and ability to function in daily life. The neurological effects can make it difficult to sleep and cause nausea. Due to it blocking how someone feels, it has a range of psychological effects that include an inability to express one’s self and process emotions adequately. This will lead to problems in relationships.
Buprenorphine is used to treat opioid use disorders, but it’s also an opioid itself. Though it’s only a partial agonist, it can cause some of the same effects and side effects as other opioid medications. If the drug is abused, it can cause some dangerous and even life-threatening side effects. However, even in high doses, buprenorphine is safer than other opioids because of its effects ceiling. When buprenorphine is taken in high doses, its effects will plateau at a certain dosage, and taking more may no longer increase the effects.
One study administered a dose that was 70 times greater than the recommended pain-relieving dose to healthy adult male volunteers, and the effects were well tolerated. Opioid-dependent people may have different experiences with high doses, but for the most part, even dangerous symptoms like respiratory depression reach a ceiling. Children may also be at higher risk than adults for experiencing dangerous symptoms.
Buprenorphine overdose may also be more likely if you are also taking other opioids or central nervous depressants like alcohol. When an opioid-dependent person enters treatment that involves buprenorphine, medical staff will make sure they have already started to exhibit withdrawal symptoms.
Withdrawal indicates that opioids have already started to leave your system and that it’s safe to administer buprenorphine. If the medication is administered too early, while another opioid is still active, it could cause an overdose.
Central nervous system depressants like benzodiazepines, barbiturates, sleeping pills, and alcohol can also cause potentiation, which means that the drugs can combine to intensify their effects.
Even though buprenorphine is unlikely to cause an overdose with normal and even high doses on its own, with a depressant in your system, even normal doses can lead to an overdose.
Buprenorphine can cause dependence, even when the drug is used in medication-assisted treatment. People who are dependent on opioids can go through treatment where more harmful opioids are replaced with buprenorphine as they go through treatment. However, you will still be dependent on opioids. To achieve complete abstinence, you may have to go through withdrawal symptoms.
Though opioids are often grouped with central nervous system depressants, they are actually in a category of their own. Opioids aren’t as dangerous as depressants during withdrawal, and they aren’t known to cause life-threatening symptoms. However, opioid withdrawal symptoms can be extremely unpleasant, causing flu-like effects.
Though it’s not usually deadly, withdrawal can be a significant barrier to sobriety. In addition to psychological and physical withdrawal symptoms, you may also experience powerful drug cravings. The combination of symptoms and compulsions to use can make it extremely difficult to resist relapse.
Opioid withdrawal can cause dehydration because of excess sweating, vomiting, and diarrhea. Without enough fluids, dehydration can lead to serious medical complications. The safest way to go through opioid withdrawal is with medical detox, and it may be dangerous to go through it completely alone.
Buprenorphine addiction is something that should be taken seriously. It may be easy to overlook because a doctor prescribes it to treat addiction, but as an opiate, it can cause severe consequences that can alter the course of your life.
Addiction treatment is a vital part of managing substance use disorders. Treatment may be the last opportunity you have before succumbing to an overdose. As mentioned earlier, one in 96 people are likely to die from an opioid overdose, and you do not want to become a statistic.
The first step in addiction treatment begins in the most intensive phase, which is medical detoxification. During detox, you will be placed in a center that offers 24-hour care for up to seven days. During this time, your body will rid itself of the toxins in your system while addiction specialists oversee your progress. Once they deem that your mind and body are stable, you will be moved into the next level of care. This can include:
The next stage of care will be determined by the severity of your addiction, how long you have been using, and if you are at high risk to relapse. During treatment, there will be many therapies that you may be placed in, which will help get to the root of your addiction. Some therapies you may attend are:
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The National Alliance of Advocates for Buprenorphine Treatment. (n.d.). Retrieved from from https://www.naabt.org/faq_answers.cfm?ID=2
Walsh, S. L., Preston, K. L., Stitzer, M. L., Cone, E. J., & Bigelow, G. E. (1994, May). Clinical pharmacology of buprenorphine: Ceiling effects at high doses. Retrieved from from https://www.ncbi.nlm.nih.gov/pubmed/8181201