How to Prepare for a Buprenorphine Induction at Home
If your doctor has recommended that you begin treatment with buprenorphine, you probably have a lot of questions. Of course, you can and should go over your treatment plan with your doctor until you feel completely comfortable. This post, though, walks you through some of the basics to give you a better idea of what to expect when beginning a buprenorphine induction at home.
What patients should know
Buprenorphine, like methadone, is a medication used to treat opioid use disorder. It replicates some of the physical effects of taking opioids, so it can eliminate cravings and allow you to resume your normal life. In fact, once you’ve settled into your buprenorphine treatment, you can expect to regain more stability in your life and relationships. You should find that you’re more comfortable and more able to focus on your work and life. Unlike opioids, however, patients taking buprenorphine do not escalate their use or spend large portions of their time seeking out more of the medication. Rather, buprenorphine treatment has been shown for decades to help people like you get your life back on track.
Once you’ve stabilized on the treatment and are feeling better, you can talk to your doctor about whether it’s best to stay on buprenorphine or slowly taper off the medication. Keep in mind that buprenorphine is a medication given to help you heal from your opioid dependence, not an addictive ‘drug.’ You may experience withdrawal if you abruptly stop the medication, but withdrawal is different from addiction. Withdrawal can also occur with abruptly stopping blood pressure or antidepressants. But nobody would say they’re ‘addicted’ to blood pressure medication or antidepressants, even if they need those medications to function normally and enjoy their lives. You’re not ‘replacing one addiction with another.’ Instead, you’re taking medication to treat your addiction and resume normal life.
Before you begin buprenorphine treatment, talk to your doctor or your Skyler Health counselor about what opioids you’re using now and whether you’ve tried buprenorphine or methadone before. The best and most effective treatment plans are designed collaboratively, and take your needs and concerns into account.
Contrary to what you may have heard, the latest treatment methods do not require you to go through opioid withdrawal before beginning buprenorphine treatment. You can start taking a microdose of buprenorphine first and gradually increase that dosage while you taper off the opioids you’ve been taking. This type of treatment is designed to be much more comfortable for you, and easier for you to stick with. Most people don’t even go through withdrawal using this method. We recommend the withdrawal-free approach at Skyler Health and are skilled at implementing it with our members.
No matter what you may have seen in the movies, on TV, or elsewhere, you do not have to go through withdrawal in order to begin your recovery.
What doctors should know
The best and most effective treatment programs are designed collaboratively with patients. Your goal should be to design a program that feels comfortable and safe for your patient — a program they can stick to, with your help.
Buprenorphine treatment significantly reduces a patient’s risk of overdose, as well as illicit drug use and infectious disease risk. It’s common for patients or family members to worry that they’re simply substituting one drug for another, so it’s helpful to stress that buprenorphine is a medication that does not induce cravings or drug-seeking behavior like typical opioids. Getting into buprenorphine treatment is the beginning of the recovery process, and will help your patient get their life back on track while reducing the severe, life-threatening risks of opioid use.
Many doctors still assume that patients beginning buprenorphine treatment must go through withdrawal. Not so. In fact, beginning with a microdose induction of buprenorphine allows the patient to avoid withdrawal. Unnecessarily putting patients through withdrawal can lead to drop out. Tapering off their opioid and cross-tapering to buprenorphine using a microdose induction is far more comfortable for patients and easier for them to stick to.
Remember, a patient who is dependent on opioids will structure their entire life around avoiding withdrawal. Withdrawal is not just painful, it’s traumatic — and it’s not necessary to achieve good outcomes. At Lucid Lane we recommend the withdrawal-free approach for most of our members for the many reasons cited above.
As a primary care physician or doctor your patient already knows, you can provide a comfortable safe space for patients who may understandably be anxious about this transition in their life and treatment. It’s unfortunately true that most doctors haven’t been trained to deal with addiction and recovery. Even among doctors who are approved to prescribe buprenorphine, very few actually do, because very few have the experience or expertise to feel comfortable designing a treatment program. That’s where Skyler Health can help, partnering with prescribing doctors to design and implement treatment programs that work. Collaborating together we can help you help your patient get their life back.
Doctors like you are on the front lines of the opioid epidemic, and buprenorphine can be a life-saving treatment for patients who truly need it.
