Buprenorphine Maintenance Treatment
INFORMATION FOR FAMILY MEMBERS
Family members of patients who have been prescribed a buprenorphine maintenance treatment for addiction often have questions about this treatment.
What is an Opioid?
Opioids are addictive narcotics in the same family as opium and heroin. This includes many prescription pain medications, such as Codeine, Vicodin, Demerol, Dilaudid, Morphine, Oxycontin, and Percodan. Methadone, LAAM (short for levo-alpha-acetyl methadol), and buprenorphine are also opioids.
Why are opioids used to treat addictions?
Many family members wonder why doctors use buprenorphine to treat opiate addictions, since it is in the same family as heroin. Some of them ask, “Isn’t this substituting one addiction for another?” But the three medications used to treat addition to heroin “methadone, LAAM and buprenorphine ” are not “just substitutions.” Many medical studies since 1965 show that maintenance treatment helps keep patients healthier, keeps them from getting into legal troubles, and prevents them from getting AIDS.
What is the right dose of Buprenorphine?
Family members of patients who have been addicted to heroin have watched as their loved ones use a drug that makes them high, or loaded, or have watched the painful withdrawal which occurs when the drug is not available. Sometimes the family has not seen the normal person for years. They may have seen the patient misuse doctors’ prescriptions for narcotics to get high. They are rightly concerned that the patient might misuse or take too much of the Buprenorphine prescribed by the doctor. They may watch the patient and notice that the patient seems drowsy, or stimulated, or restless, and think that the Buprenorphine will be just as bad as heroin.
Every opioid can have stimulating or sedating effects, especially in the first weeks of treatment. The “right” dose of Buprenorphine is the one that allows the patient to feel and act normally. It can sometimes take a few weeks to find the right dose. During the first few weeks, the dose may be too high, or too low, which can lead to withdrawal, daytime sleepiness, or trouble sleeping at night. The patient may ask that family members help keep track of the timing of these symptoms, and write them down. Then the doctor can use all these clues to adjust the amount and time of day for Buprenorphine doses.
Once the right dose is found, it is important to take it on time in a regular way, so the patient’s body and brain can work well.
How can the family support good treatment?
Even though maintenance treatment for heroin addiction works very well, it is NOT a cure. This means that the patient will continue to need the stable dose of Buprenorphine, with regular monitoring by the doctor. This is similar to other chronic diseases, such as diabetes, or asthma. These illnesses can be treated, but there is no permanent cure, so patients often stay on the same medication for a long time. The best way to help and support the patient is to encourage regular medical care, and encourage the patient not to skip or forget to take the medication.
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