Buprenorphine Treatment

Hi, thank you for coming back for the latest edition of Beyond Primary Care’s blog- Buprenorphine treatment. In Beyond Primary Care blogs we highlight healthcare news, advice for medical conditions, and how membership for care works! Beyond Primary Care is an insurance free, membership based family medicine clinic. Beyond Primary Care is the highest rated Direct Primary Care clinic serving patients in Ann Arbor and throughout Washtenaw, Livingston, and Wayne counties giving families and employers peace of mind about healthcare costs by providing affordable and accessible primary care services.

In this blog post, we wanted to introduce our patients and prospective patients on Buprenorphine treatment.

Why Is Fentanyl Contributing To A Crisis

You may have heard of previous drug epidemics. In the 1980s it was crack cocaine. In the 2000s it was prescription opioids. Now, a synthetic opioid more powerful than heroin called fentanyl is responsible for a majority of drug overdose deaths. Drug overdoses are are leading cause of death among young adults aged 18-45. 

Fentanyl is an important prescription and safe medication when administered or dosed appropriately by a trained physician. It is used to treat severe pain, typically the pain associated with some cancers. 

However, illicit drug manufacturers (eg- cartels) press chemicals such as fentanyl into pills, which are counterfeited to resemble prescription medications for Attention Deficit Hyperactivity Disorder (ADHD), anxiety, and pain. In fact, the DEA reports that nearly half of all counterfeit pills tested contains fentanyl. This can be dangerous because people often consume these pills without realizing fentanyl was in it, leading to an accidental overdose or death. 

Harm Reduction

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), harm reduction is an evidence-based approach that is critical to engaging with people who use drugs. Simply, it is exactly what is sounds like- reducing the harm associated with using drugs through a variety of public health interventions. It does not treat drug use as a moral failing. Harm reduction is a multi-dimensional approach, varies state-to-state, and importantly, doesn’t offer a one-size fits all approach or perfect solution to the fentanyl crisis. 

As example, one aspect of harm reduction is the result of the Purdue Pharma and Sackler family $6 billion settlement for its role in the opioid crisis in the 2000s. State and local governments have invested significant funding into mental health programs, prevention in schools, and addiction treatment for people who are uninsured. Other governments invested in law enforcement and capital projects to improve jails, police efforts, and criminal justice including drug courts. 

Another aspect of harm reduction is the opioid reversal medication, Naloxone. In 2023, Naloxone was approved as an over-the-counter medication increasing its accessibility to anyone. 

Buprenorphine Treatment

Buprenorphine medication (brands include: Suboxone, Zubsolv) is another important medication used in harm reduction and opioid treatment. There is also a long-acting injectable form of Buprenorphine called Sublocade. Buprenorphine is an opioid. It binds to the same receipts in the human brain as other opioids, such as heroin, morphine, fentanyl, and oxycodone. However, by doing so, it blunts intoxication with these other drugs resulting in less cravings, allowing people to transition back from a life of addiction to normalcy and safety. 

Using Buprenorphine is not simply substituting one drug for another drug. Buprenorphine is a researched and validated medication that when prescribed under the direction of a licensed physician can break the misuse cycle of illicitly obtained medications that may lead to overdose or death of a person. Buprenorphine is only about 40% as strong as other opioids, because it is only a ‘partial’ agonist. This means it causes much less euphoria- i.e. ‘dopamine release.’

Oral Buprenorphine stays in the human brain for approximately five days. Let me repeat that. FIVE DAYS. Again, specialized formulations such as Sublocade can last longer. This is good, errr- great. As comparison, most opioids last 6-8 hours in the body. Fentanyl lasts a few hours. Heroin lasts about 4 hours. 

Lastly, Buprenorphine sticks to those brain receptors better than other opioids discovered. What this means if a person were to use another drug then use Buprenorphine immediately after this, the Buprenorphine would kick the other opioids off the receptor and stick to those receptors better and stronger, taking up all the space, leaving the other drugs not able to get to where they need to be in the body to be active. 

Many physicians, addiction experts, and recovery advocates agree that buprenorphine saves lives. In fact, the U.S. government has been lightening up the restrictions placed on doctors and nurses in an attempt to increase the availability of buprenorphine prescribers. Yet, a study published in July 2023 in the Journal of the American Medical Association found most doctor offices don’t prescribe these medications to their patients. What this means is that real solutions and access to this life saving medication is complex and time-consuming. The U.S. needs better strategies in educating physicians on prescribing Buprenorphine as well as expanding access to patients.

Where To Find Doctors Who Prescribe Buprenorphine

In addition to being a board certified family medicine doctor, Dr. Jeff O’Boyle is also a board certified through the American Board of Preventative Medicine in Addiction Medicine. Beyond Primary Care utilizes buprenorphine products such as Sublocade, Suboxone, and Zubsolv at Beyond Primary Care in Ann Arbor, Michigan. Our clinic uses an eclectic and personalized approach towards assessing your medication needs. There is not a ‘cookie cutter,’ one-size fits all plan. In addition to a thorough health history, Dr. Jeff O’Boyle will ask about your family, where your quality of life is being most affected, and—most importantly—what you want to do.

Reach Out For Help

If you think some health concerns of what you may be experiencing may be due to excessive opioid consumption, or if you notice any coworkers, friends, or family members silently struggling, send them a link to this post so that they can join the conversation!