Buprenorphine for Pain Management in Plano, TX

Buprenorphine is approved by the US Food and Drug Administration (FDA) for acute pain, chronic pain, opioid use disorder, or opioid dependence, depending on the formulation.

Buprenorphine also reduces the potential for respiratory depression and death compared with conventional opioids.

In addition to a decreased risk of respiratory depression, other tolerability factors like constipation are more favorable with buprenorphine.

In addition, a comparison of adverse events reported in clinical trials for buprenorphine buccal film and ER formulations of oxycodone, hydromorphone, and oxymorphone showed that the proportion of patients who experienced nausea, vomiting, constipation, headache, dizziness, somnolence, anxiety, and dry mouth was lower with buprenorphine buccal film than with conventional opioids.

Overall, the safety data and additional benefits of buprenorphine suggest that it has a lower risk of adverse events compared with conventional opioids, most notably with respiratory depression. However, all opioids, including buprenorphine, carry the risk of adverse events and addiction potential, depending on the dose.

Common medical problems resulting from other long-acting opioids arise less frequently with buprenorphine. These problems include sleep apnea, low testosterone, sexual dysfunction, osteopenia, opioid-induced hyperalgesia, mood disorders (depression and anxiety), and dysregulation of the hypothalamic pituitary adrenal axis. A growing body of literature shows improved pain relief on buprenorphine after conversion from other long-acting opioids.

For elderly patients using long-term opioids, transitioning to buprenorphine lowers the risk of accidental overdose and potentially lowers the risk of medical complications (e.g., sleep apnea and hypogonadism). For this reason, buprenorphine may be a safer choice for elderly patients already on daily opioid treatment.

There appears to be:

Decreased risk of opioid overdose (risk increases when combined with alcohol, benzodiazepines, and other central nervous system depressants)

Decreased risk of addiction, tolerance, and withdrawal

Decreased constipation, immune suppression, and hypogonadism (reduction of testosterone)

Decreased depression, suicidal ideation, dysphoria, anxiety, hostility

Decreased sedation, hyperalgesia

Decreased respiratory depression

Webster, L. et al. Understanding Buprenorphine for Use in Chronic Pain: Expert Opinion. Pain Medicine, 21(4), 2020, 714–723.

Hale, M. et al. Benefit-Risk Analysis of Buprenorphine for Pain Management. Journal of Pain Research 2021:14 1359–1369.

DeFries, T. et al. Buprenorphine: An Overview for Clinicians. California Healthcare Foundation. https://www.chcf.org/publication/buprenorphine-overview-clinicians/

US Department of Veteran Affairs Clinician Guide: Buprenorphine for Chronic Pain:

https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Academic_Detailing_Educational_Material_Catalog/IB_1497_Provider_BupChronicPain.pdf