As the opioid epidemic continues to represent a growing problem in the United States, having a wealth of treatment options is more important than ever. One form of treatment, called medication-assisted treatment (MAT), uses a drug called buprenorphine to help alleviate drug opioid withdrawal symptoms. As an opioid itself, buprenorphine can stop recovering substance users from experiencing uncomfortable withdrawal symptoms and cravings. However, it’s different enough from other opioids in that it doesn’t cause intoxication or euphoria easily.
How does buprenorphine work in the body and how long does it stay in your system? Learn more about these opioid medications and how they are used to treat substance use disorders.
Buprenorphine is an opioid that works in the body similarly to other opioids but with some unique properties. There are three major opioid receptors in the body, and buprenorphine interacts with all three. However, it acts as a partial agonist with one receptor, called the mu- opioid receptor (MOR), which means it binds to the receptor but only partially activates it. At low doses, buprenorphine acts in a way that’s similar to other opioids, but at high doses, buprenorphine reaches an effects ceiling.
Most opioids such as heroin and morphine will cause growing effects based on the size of the dose taken. The higher the dose; the more intense the experience. However, after a specific dose, buprenorphine will no longer increase in effectiveness, which makes it difficult to abuse.
Buprenorphine reacts with the other receptors as an antagonist, which means that it binds to the KOR and DOR receptors but prevents them from activating. So, when buprenorphine enters your brain, it partially activates one opioid receptor and deactivates the other two. Plus, you can only take so much before the drug reaches the limits of its effectiveness.
All of this makes buprenorphine an ideal medication to treat opioid addiction. It can satisfy cravings without causing intoxication, euphoria, or significant sedation like other opioids would.
When someone who has a substance use disorder takes buprenorphine, they can go about their daily life without feeling cravings, withdrawal symptoms, or intoxication. It can also allow one to enter treatment without having to go through a detox process.
Buprenorphine does cause physical dependence like other opioids. For that reason, treatment centers usually don’t administer the drug until an opioid use disorder is confirmed. Usually, that means it is given to a client after they start to show signs of opioid withdrawal.
Prolonged use of the medication can cause your body to adapt to it, integrating it into normal functions. If you stop using it, you’ll experience withdrawal symptoms. To achieve complete abstinence from opioid use, clients will go through a weaning-off process after treatment. This process can last up to a year, depending on the client’s individual needs.
It’s important to understand biological half-lives to understand why some drugs pass right through you while others seem to linger. A half-life is the measurement of the time it takes for your body to remove half of a biological substance.
When a psychoactive drug enters your system, it’s half-life is the length of time it takes your body to process it through the liver and kidneys, reducing it to half of its original concentration in your blood.
When a drug reaches the end of its half-life, its effects may start to diminish. When it comes to medications, a substance’s half-life can help determine the amount of time it will work efficiently. Drugs with shorter half-lives need to be readministered more often than ones with longer half-lives.
For instance, ibuprofen has a half-life of two to four hours. So drugs that contain ibuprofen, like Advil, have labels that recommend taking a dose every four to six hours because, after that period, the drug may no longer be very effective. Your body will have eliminated enough of the drug to make it safe for you to take another dose.
On the other hand, buprenorphine has a much longer half-life of between 20 to 70 hours, most typically around 40 hours. It’s most effective for up to 24 hours, after which the drug will begin to lose effectiveness and people being treated for opioid dependency will start to feel symptoms again. In buprenorphine-assisted treatment, the drug is typically administered once per day until it’s time to start weaning off the drug.
Buprenorphine has a half-life of around 40 hours, and it’s most effective in the first 24 hours of taking the medication, but that doesn’t mean the drug only stays in your system for a day or two.
There is a significant difference between a drug’s biological half-life and the amount of time a drug will be detectable in your system. If you have just finished buprenorphine treatment, or if you’ve otherwise stopped using, it may be essential for you to know how long the chemical is going to stick around. If you are starting a new job, you may have to take a drug test, and may be wondering if you need to disclose your buprenorphine treatment.
Generally, it can take around eight days for buprenorphine to clear out of your system, but it’s not necessarily the same for everyone. Various factors influence your body’s ability to purge a substance completely.
Your age can determine the speed at which you metabolize certain substances like buprenorphine. People over age 65 often metabolize medications more slowly. Your body weight, height, and body fat percentage can also play a role in the speed at which you metabolize substances. Drugs containing buprenorphine like Suboxone, are lipophilic, which means they stick to fat cells. Because of this, buprenorphine can be stored in fat for longer periods.
Other factors can also influence the speed at which buprenorphine is metabolized, such as genetics, liver function, and metabolic rate. Staying hydrated can also help you clear your system more quickly, whereas a dehydrated person might retain chemicals for more extended periods.
One of the most significant determining factors in the length of time buprenorphine stays in your system is the size of your last dose. The amount you take compared to your body weight can determine how quickly your body can purge the drug from your system.
If you had been weaning off the drug before quitting, your last dose would have been fairly low, possibly around 2 mg (milligrams) or smaller. The time you spent using the drug will also cause it to stay in your system longer. If you’ve been going through medication-assisted treatment with buprenorphine, you may have been using the drug for a year or more.
The metabolic process of Subutex in the liver creates metabolites that often stay in the body longer than the drug itself. Modern drug tests have the capability of detecting its presence in the system well after eight days. It depends on the person, but it can be detected in the system and produce positive results for up to 11 days for buprenorphine.
While blood tests are invasive, they can only detect substances shortly after they’ve been ingested. The window for buprenorphine is even smaller — the best time for a blood test is a little over two hours after the last dose. Saliva tests are used most commonly because they’re noninvasive and easy to administer. The tests can work for a few days, or up to a week after the last dose of Subutex.
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