Advantages of Buprenorphine hydrochlorideas compared to Methadone in the

clinical setting for treatment of opioid dependency and pain relief

Buprenorphine hydrochloride is more commonly replacing methadone as medication-

assisted treatment (MAT) in patients with addiction to morphine, heroin and other opiates. The

medication was approved for clinical use in October 2002 by the Food and Drug Administration

(FDA), making it relatively new when compared to methadone use in the U.S. over the past four

decades. Buprenorphine provides multiple benefits to the provider and patient when compared

to those of traditional methadone treatment. The first is improved accessibility to the medication

by the patient. Methadone administration is typically dispensed in highly regulated clinics

whereas buprenorphine is the first drug to treat opioid dependency that may be prescribed and

dispensed by a qualified MD in their office. Patients with dependency to morphine, heroin and

other opiates may have had to wait for long periods of time before methadone clinics had

available space to treat them thus delaying treatment. As stated in the Drug Addiction Treatment

Act of 2000 (Data 2000), qualified clinicians may prescribe Buprenorphine in the office,

community hospital, health department or correctional facility. The ability of the provider to

directly prescribe and dispense Buprenorphine allows greater patient contact and monitoring by

the physician thereby reducing medication non-compliance in the patient thru regular contact.

The qualified provider may also treat a greater number of patients with opioid dependency while

concurrently providing adjunct behavioral therapies enhancing continuity of holistic care.

Buprenorphine may offer superior suppression of withdrawal symptoms and possess

fewer withdrawal symptoms of its own. Buprenorphine effects are also considered non-sedating

providing a greater sense of normalcy for the patient. This non-sedating effect is desirable in
treating the hospitalized patient for pain as well. Opioid related respiratory depression is a life-

threatening adverse effect that may be significantly reduced by choosing buprenorphine in place

of traditional opioids for patient pain management.

It is important to note that buprenorphine, like methadone, is also an opioid capable of

producing intoxication and therefore dependency. Causational factors of addiction should be

evaluated on an individual patient basis when considering buprenorphine in the line of treatment

for opioid dependency or acute pain relief.

 References

Gryczynski,et al (2013). Patient Perspectives on Choosing Buprenorphine Over Methadone in an

Urban, Equal Access System. The American Journal on Addictions, 22: 285291, 2013.

American Academy of Addiction Psychiatry. https://doi/10.1111/j.1521-

0391.2012.12004.x