No. With successful buprenorphine treatment, the compulsive behavior, the loss of control of drug use, the constant cravings, and all of the other hallmarks of addiction vanish. When all signs and symptoms of the disease of addiction vanish, we call that remission, not switching addictions.The key to understanding this is knowing the difference between physical dependence and addiction. Buprenorphine will maintain some of the preexisting physical dependence, but that is easily managed medically and eventually resolved with a slow taper off of the buprenorphine when the patient is ready. Physical dependence, unlike addiction, is not a dangerous medical condition that requires treatment. Addiction is damaging and life-threatening, while physical dependence is an inconvenience, and is normal physiology for anyone taking large doses of opioids for an extended period of time.
Buprenorphine is a partial opioid agonist, which makes effectiveness unique. For purposes of treatment for opioid addiction, buprenorphine:
At the appropriate dose buprenorphine treatment may:
Buprenorphine can block the effects of opioids and can precipitate, or bring on withdrawal symptoms if an opioid is in the bloodstream of an opioid addicted person. This is the result of the high affinity buprenorphine has to the opioid receptors. The affinity refers to the strength of attraction and likelihood of a substance to bind with the opioid receptors in the brain. Buprenorphine has a higher affinity than other opioids and as such will compete for the receptor and win. Buprenorphine will "knock off" other opioids and occupy that receptor blocking other opioids from attaching to it. If there is enough Buprenorphine to knock the opioids off the receptors but not enough to occupy and satisfy the receptors, withdrawal symptoms can occur. If this happens, the treatment is more buprenorphine until withdrawal symptoms disappear.
The most common side effects are:
More serious or concerning side effects may be experienced if the dose is too high (over-medicated) or too low (withdrawal symptoms).Buprenorphine induction and maintenance is closely monitored by the nursing staff and physician.
Center for Substance Abuse Treatment. Buprenorphine: A Guide for Nurses. DHHS Pub. No. (SMA) 09-4376. Technical Assistance Publication (TAP) Series, No. 30. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2009.