Buprenorphine: Considerations for Pain Management
Open accessAbstract
New effective analgesics are needed for the treatment of pain. Buprenorphine, a partial mu-opioid agonist which has been in clinical use for over 25 years, has been found to be amenable to new formulation technology based on its physiochemical and pharmacological profile. Buprenorphine is marketed as parenteral, sublingual, and transdermal formulations. Unlike full mu-opioid agonists, at higher doses, buprenorphine's physiological and subjective effects, including euphoria, reach a plateau. This ceiling may limit the abuse potential and may result in a wider safety margin. Buprenorphine has been used for the treatment of acute and chronic pain, as a supplement to anesthesia, and for behavioral and psychiatric disorders including treatment for opioid addiction. Prolonged use of buprenorphine can result in physical dependence. However, withdrawal symptoms appear to be mild to moderate in intensity compared with those of full mu agonists. Overdoses have primarily involved buprenorphine taken in combination with other central nervous system depressants.
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Opioid dependence is treated using maintenance therapy, leading to abstinence supported by a prescribed substitute such as buprenorphine.
“Opioid dependence is treated using maintenance therapy, leading to abstinence supported by a prescribed substitute (such as buprenorphine, a semi-synthetic opioid; Johnson et al., 2005; Joint Formulary Committee, 2020).”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Johnson et al., 2005
The Introduction describes buprenorphine as a derivative of the morphine alkaloid thebaine and says its sublingual formulation is approved to treat opioid addiction. The Buprenorphine Alone section also reports its use to treat opioid dependence. These passages support buprenorphine as the opioid medication in the claim, but do not establish that maintenance therapy leads to abstinence. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOpioid-substitution medications manage physical aspects of addiction.
“Opioid-substitution medications manage physical aspects of addiction; however, difficulties with emotional regulation and avoidance perpetuate continued substance misuse.”
From “I don’t want to take buprenorphine for the rest of my life”: Acceptance and Commitment Therapy for a Client Struggling to Reduce Low-Dose Buprenorphine (a Hermeneutic Single-Case Efficacy Design) (2023) · cites this paper as Johnson et al., 2005
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References 268 · Cited by 290
Part of this paper’s reference list could not be split into single entries.
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- Authors
- Johnson, R. E., Fudala, P. J., & Payne, R.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Johnson, Rolley E.
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2005-03
- Volume
- 29
- Issue
- 3
- Pages
- 297-326
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W2122130641
- Cited by
- 290
- References
- 268
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 11 · 2023: 9 · 2022: 14 · 2021: 11 · 2020: 9 · 2019: 13 · 2018: 16 · 2017: 14 · 2016: 12 · 2015: 10 · 2014: 20 · 2013: 17 · 2012: 18
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Purdue Pharma
- Topics
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
- Keywords
- buprenorphine, pain management, opioid analgesics, sublingual formulation, transdermal formulations, ceiling effect, abuse liability, opioid use disorder, withdrawal symptoms, opioid overdose, opioid dependence treatment, chronic pain, acute pain
- MeSH terms
- Analgesics, Opioid, Buprenorphine, Humans, Pain
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