Suboxone (buprenorphine and naloxone) is a prescription medication approved to treat opioid use disorder.
It is also sometimes prescribed off-label for pain management as an alternative to opioids.
Buprenorphine, one of the active ingredients in Suboxone, acts as a partial opioid agonist.
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This means it provides similar analgesic effects to opioids like oxycodone without severe side effects like respiratory depression.
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What Is Suboxone and What Is It Used For?
Suboxone helps to deter substance abuse.
It contains buprenorphine, a partial-opioid agonist, and naloxone, an opioid antagonist.
Buprenorphine-naxolone therapy has been approved by the Food and Drug Administration (FDA) to treat opioid dependence.
Suboxone can be prescribed “off-label” for chronic pain management.
The combination of buprenorphine and naloxone may reverse opioid-inducedhyperalgesia, which is an increased sensitivity to pain.
Other Buprenorphine-Containing Medications
Other brand medications contain buprenorphine and are used to treat opioid disorders.
They include:
How Does Suboxone Work for Pain?
It binds to the same receptors in the brain that opioids bind to.
These receptors are responsible for pain relief.
It also stays attached to those receptors for longer, which means it has a prolonged effect.
Because buprenorphine only partially activates the receptors it attaches to, it is less potent than opioids.
Finally, it doesn’t create strong feelings of euphoria, as opioids do.
It’s added to decrease the potential for buprenorphine to be abused by injection.
Advantages vs.
Dental problems have been reported with buprenorphine formulations that are dissolved in the mouth.
Mixing buprenorphine with other drugs like benzodiazepines can be lethal.
A 2017 review found that buprenorphine in any formulation was effective for the treatment of chronic pain.
Importantly, no serious adverse effects were reported in any of the studies.
Those taking buprenorphine could also be less likely to develop tolerance.
Some researchers also hypothesize that buprenorphine may be able to help people withopioid-inducedhyperalgesia.
Some researchers think this condition could explain why opioids stop working for some people.
Still, there is no general agreement on whether buprenorphine should be used for this purpose.
Currently, the few studies examining the effect of buprenorphine on chronic pain are too dissimilar in their approaches.
This makes them difficult to compare.
Before buprenorphine can become a standard treatment for chronic pain, a few issues need to be resolved.
For example, past studies have rated patient pain in different ways.
This makes it difficult to analyze the data.Pain rating scalesin buprenorphine studies need to be standardized.
The CDC has guidelines in place for the treatment of chronic pain in the primary care setting.
The guidelines recommendopioidsonly when non-opioid treatments haven’t worked.
They also recommend prescribing opioids at the lowest possible dose.
In this context, buprenorphine could essentially be considered an opioid alternative.
Suboxone is not as dangerous as the opioids that are often prescribed for chronic pain.
It is currently used to treat opioid addiction.
Although it is not yet an FDA-approved treatment for chronic pain, some healthcare providers prescribe it off-label.
Buprenorphine and Suboxone can have side effects, including sleep problems, headache, and stomach pain.
Serious side effects can also occur.
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