Approved by the U.S. Food and Drug Administration in 2002, buprenorphine is one of the most popular medications used in medication-assisted treatment (MAT) for opioid addiction. Since it is generally considered safe and effective, a buprenorphine overdose isn’t something that crosses most people’s minds.
But even though buprenorphine is supposed to help people suffering from pain or opioid addiction, it doesn’t come without risks. In fact, it can lead to an overdose that is no less dangerous than that of other opioids.
This article will explain what you should know about a buprenorphine overdose, including its symptoms, causes, and prevention.
What is Buprenorphine?
Buprenorphine is a partial opioid agonist medication commonly prescribed to treat opioid use disorder (OUD). It can also be used to alleviate acute and chronic pain that cannot be relieved by non-opioid medications.
As a semi-synthetic opioid, buprenorphine is derived from thebaine, an opium alkaloid up to 50 times stronger than morphine.
Buprenorphine used for pain treatment is available in the following formulations:
- Buccal film (Belbuca®)
- Injection (Buprenex®)
- Skin patch (Butrans®)
Meanwhile, buprenorphine used for treating opioid addiction is available in the form of:
- Extended-release injections (Sublocade®)
- Subdermal implants (Probuphine®)
- Tablets (Subutex®)
To treat OUD, buprenorphine is often prescribed as a combination drug containing naloxone, an opioid antagonist used to reverse an opioid overdose. Most commonly, buprenorphine/naloxone is sold under the brand names Suboxone® and Zubsolv®.
Buprenorphine Usage in the US
Here are the most recent statistics on buprenorphine use, misuse, and overdose in the United States:
- In 2020, more than 2.8 million buprenorphine prescriptions were issued to just over 330,000 patients.
- Between July 2019 and June 2021, buprenorphine was involved in 2.2% (1,955) of all drug overdose deaths (89,111). Roughly 93% of these deaths were linked to the use of other prescription medications.
- In 2021, buprenorphine was the fifth-most commonly misused prescription painkiller among people over the age of 12, with nearly 9% of them misusing this drug specifically. Moreover, 22.2% of buprenorphine users reported misusing the drug in the past year.
Can You Overdose on Buprenorphine?
Yes, you can overdose on buprenorphine. However, buprenorphine generally carries a lower risk of overdose than most other opioids, such as hydrocodone or oxycodone.
Simply put, buprenorphine activates opioid receptors partially and thus usually produces milder euphoric and sedating effects than full opioid agonists. This makes buprenorphine abuse less likely than that of other opioids.
It also has a “ceiling effect,” meaning that it peaks in intensity at a certain dosage. In other words, taking a larger amount of buprenorphine won’t enhance its effects, which minimizes the risk of abuse and buprenorphine overdose.
That said, even though a buprenorphine overdose isn’t that common, it is still possible, especially if you have a low tolerance to opioids or take it in combination with other drugs.
Is Buprenorphine Safe?
When taken as prescribed, buprenorphine is a relatively safe medication. Classified as a Schedule III controlled substance, it carries a lower risk for abuse and dependence than other opioids.
Even so, buprenorphine is still an opioid, which can lead to addiction and a potentially lethal overdose. Moreover, like any medication, it may cause various side effects, some of which can be life-threatening.
The most common side effects of buprenorphine are:
- Agitation
- Confusion
- Constipation
- Drowsiness
- Dry mouth
- Headache
- Lightheadedness
- Nausea
- Stomach ache
- Sweating
- Vomiting
To reduce the risk of side effects, addiction, and overdose, closely follow your doctor’s instructions while taking this medication. Do not alter the buprenorphine dosage or frequency of use without consulting with them.
As an opioid, buprenorphine is also associated with the risk of respiratory depression. If you experience difficulty breathing after taking buprenorphine, seek medical help immediately, as this may also be a sign of a buprenorphine overdose.
Signs and Symptoms of Buprenorphine Overdose
The most common signs and symptoms of a buprenorphine overdose are:
- Blue, pale lips
- Cold and clammy skin
- Coma
- Decreased blood pressure
- Fainting
- Miotic pupils
- Severe drowsiness
- Slowed and shallow breathing
Some less common symptoms of a buprenorphine overdose may include:
- Excessive sweating
- Extreme confusion
- Nausea
- Seizures
- Slowed heart rate
- Stomach cramps
- Vomiting
These symptoms typically only occur when an overdose is caused by combining buprenorphine with another substance, such as alcohol or other central nervous system (CNS) depressants.
If you or your loved one is exhibiting signs of a buprenorphine overdose, call 911. Although it is relatively uncommon, a buprenorphine overdose can be fatal if not treated promptly.
How Does Buprenorphine Affect Your Body?
Depending on the purpose of use, buprenorphine affects your body by alleviating either pain or opioid withdrawal symptoms. When taken for pain relief, buprenorphine attaches to opioid receptors, preventing pain signals from reaching the brain. As a result, it reduces the sensation of pain and discomfort.
When used to treat OUD, buprenorphine binds to opioid receptors in the central nervous system, dislodging other opioids and preventing them from attaching to these receptors.
As a partial opioid agonist, buprenorphine doesn’t fully activate opioid receptors and produces weaker euphoric effects than other opioids while still satisfying opioid cravings. In turn, taking buprenorphine might help people quit more potent opioids such as heroin, prevent opioid abuse, and thus reduce the risk of an opioid overdose.
However, while buprenorphine can help mitigate opioid cravings and other withdrawal symptoms, there’s a risk of developing an addiction to buprenorphine, i.e., swapping one opioid addiction for another.
How Long Do Buprenorphine Effects Last?
The effects of buprenorphine last anywhere between 6 and 72 hours, depending on the dose, metabolism, and consumption method, among other factors. As a long-acting opioid, buprenorphine is slowly released into the system but works fairly quickly, usually within 30–60 minutes after consumption.
What Causes Buprenorphine Overdose?
The main causes of a buprenorphine overdose are:
- Low opioid tolerance. Experienced opioid users aren’t likely to overdose on buprenorphine. However, opioid-naïve individuals (people who don’t take opioids regularly and have little to no tolerance to them) are at an increased risk of a buprenorphine overdose.
- Mixing buprenorphine with other substances. More often than not, a buprenorphine overdose is caused by taking buprenorphine with other CNS depressants, such as alcohol, tranquilizers, sedatives, benzodiazepines, and other opioids. Certain herbal medicines (e.g., St. John’s wort) can also interact with buprenorphine.
- Buprenorphine abuse. Taking buprenorphine in any other way than prescribed constitutes opioid abuse and may lead to a buprenorphine overdose. You should never take buprenorphine that wasn’t prescribed to you or take it for a longer time, more often, or at larger doses than prescribed.
Now that you know what causes a buprenorphine overdose, here are some tips to prevent it:
- Always take buprenorphine as prescribed by your healthcare provider.
- Don’t share your medication with others or take other people’s medication.
- Store buprenorphine safely, away from children and pets.
- If you have unused buprenorphine, follow the FDA guidelines to dispose of it safely.
- Inform your doctor about any other medications, including supplements and herbal medicines.
Buprenorphine Addiction
Buprenorphine addiction is a treatable disease characterized by continued buprenorphine use despite its negative effects on your life. Although buprenorphine is associated with a lower risk of addiction than most other opioids, anyone taking it—be it for pain relief or OUD treatment—can become addicted to it.
As an opioid, buprenorphine alters not only the way the brain interprets pain but also the brain itself. It prevents endorphin production while, at the same time, increasing that of opioid receptors.
Due to these neurobiological changes in the brain, buprenorphine use may lead to tolerance, physical dependence, and addiction. These risks are particularly high if you abuse buprenorphine to achieve a quicker or stronger “high” (e.g., by crushing tablets and snorting them).
Some tell-tale signs and symptoms of buprenorphine addiction are:
- Becoming socially withdrawn
- Taking buprenorphine with other substances to enhance its effects
- Spending a great deal of time obtaining, using, and recovering from buprenorphine
- Neglecting professional obligations
- Showing less interest in activities that used to bring joy
- Having trouble stopping or reducing buprenorphine use
- Lying, stealing, doctor shopping, and forging prescriptions to obtain buprenorphine
- Experiencing intense cravings when not taking the drug
Buprenorphine Withdrawal Symptoms
Buprenorphine withdrawal symptoms occur when people who have developed an addiction to buprenorphine quit the medication.
The most common buprenorphine withdrawal symptoms include:
- Anxiety
- Appetite loss
- Buprenorphine cravings
- Depression
- Diarrhea
- Fatigue
- Fever
- Goosebumps
- Irritability
- Joint pain
- Muscle aches
- Nausea
- Sleep problems
- Sweating
- Vomiting
Buprenorphine withdrawal symptoms usually start within the first 72 hours of quitting the drug. While the physical symptoms typically subside within a month, psychological symptoms (e.g., cravings, depression, and anxiety) may linger for several weeks or months.
Since these symptoms can be very uncomfortable, painful, and even potentially life-threatening, quitting buprenorphine without medical supervision is neither easy nor recommended.
Abruptly quitting the drug can aggravate these symptoms even more. It also increases the risk of relapse, which is very dangerous since it can easily lead to a buprenorphine overdose due to decreased tolerance for the drug.
ANR Treatment for Buprenorphine Addiction
Accelerated Neuro-Regulation (ANR) is a groundbreaking buprenorphine addiction treatment designed to help people overcome opioid dependence safely, quickly, and effectively.
Unlike traditional opioid addiction treatments, such as medication-assisted treatment (MAT), ANR tackles the root cause of addiction by re-regulating the endorphin-receptor system.
Since it restores your brain to its normal state, the ANR treatment eliminates opioid withdrawal symptoms, including cravings, and negates the risk of relapse. As such, it can help you achieve long-term recovery from opioid addiction.
Most importantly, ANR doesn’t involve any opioid-replacement drugs. It doesn’t put you at risk of becoming addicted to buprenorphine, methadone, or other opioids.
The ANR treatment is not only effective but also very safe. Every treatment is tailored to each patient’s individual needs and medical history, making it suitable even for those with complex health conditions. Moreover, the procedure is carried out under sedation by highly experienced medical professionals in an ICU setting at an accredited hospital.
To get started with the ANR treatment, contact us today and book a free consultation!
Key Takeaways
If there’s one thing you should take away from this article, it’s that even though a buprenorphine overdose is far less common than that of other opioids, it can still happen. Luckily, you can prevent it by taking it as per your doctor’s recommendations.
Now, let’s go over the key points we covered:
- Buprenorphine is a potent opioid medication used to relieve pain and treat opioid addiction.
- You can overdose on buprenorphine if you have a low tolerance to opioids, take it with other substances, or take it in other ways than prescribed.
- Some signs of a buprenorphine overdose you should look out for include constricted pupils, loss of consciousness, difficulty breathing, and low blood pressure.
Dr. Waismann identified the biological roots of opioid dependency, Since then he has successfully treated more than 24,000 patients worldwide that are struggling with opioid addiction.
Throughout his career, he has lectured and educated health professionals in dozens of countries around the world to this day.
