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Immediate Access for help and advice
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Opiate Butrans Patches Explained

What Are Opiate Patches

Opiate patches are dermal patches which once applied to the skin release an opiate, into a person’s system comparatively slowly and steadily. The patch releases a controlled dose of the substance in over a longer time period, rather than suddenly and all at once, as in the case of an opiate injected medically or recreationally (or abused in various other ways including smoking).

Although there is the potential for abuse, the comparatively slow-release mechanism – typically delivering their contents over a period of several days – of opiate patches means that they do not produce the same “high” as other methods of opioid consumption, and are therefore a preferred option for many doctors prescribing them for the treatment of both acute and chronic pain. They are also a popular option for treating opioid addiction.

Opiate patches come in a range of formats, shapes and sizes, varying from one brand to another. For anyone unfamiliar with dermal patches, the closest equivalent may be a waterproof (i.e., plastic rather than fabric) sticking plaster – though, obviously, worn not over a wound but applied to a patch of clear skin.

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Brand and Other Names for Butrans Patches

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Opiate patches typically contain the active ingredient buprenorphine (chemical formula C29H41NO4), an opioid produced and sold under a variety of brand names worldwide, including Butrans, Subutex, Cizdol, Suboxone, Zubsolv, Bunavail, Sublocade, Probuphine, Temgesic, Buprenex, Butec and Norspan.

Because the patent for Butrans, the original buprenorphine patch, has now expired, a host of generic options have reached the market in different locations around the world, and as a result, many more brand names are likely to be marketed going forwards.

Legal status of opiate butrans patches in the UK

In the UK, buprenorphine is a class-C controlled substance, illegal to possess except with a valid prescription.

Duration of Action

Opiate patches can vary from one brand to another in terms of their duration of action, with patches now available which deliver the drug over periods ranging from three to seven days. Both Butrans and Butec patches, available via the NHS, come in seven-day formats with different dosages available: five, ten, 15 and 20 micrograms per hour.

Phamacology and Pharmacokinetics of Opiate Butrans Patches

Opioids bind to specific opioid receptors in the brain and central nervous system, triggering signals to certain parts of the brain to initiate the so-called “opioid effect”: blocking pain, slowing breathing, and having a generally calming effect. They also act directly on a part of the brain called the nucleus accumbens, causing the release of dopamine, a chemical associated with motivation and reward.

Buprenorphine specifically binds to the mu-, kappa- and delta-opioid receptors (MOR, KOR and DOR respectively), and to the nociceptin receptor (NOP, ORL-1), making it a so-called non-selective, mixed agonist–antagonist opioid receptor modulator.

Buprenorphine is metabolised (by the liver) into the chemical norbuprenorphine, which is then excreted into bile and passed out primarily in faeces. It has a mean elimination half-life (the time after which half of a substance is removed from the body) of 37 hours.

Medical Uses and Effectiveness of Opiate Butrans Patches

Opiate patches are used to relieve both acute and chronic pain – but because buprenorphine is potentially habit-forming, its use in pain management needs to be strictly controlled and long-term use is viewed as problematic; however, it is often the preferred option, and highly effective, in the treatment of individuals suffering chronic pain who are expected to require pain medication for a prolonged period and who for various reasons (for example, an inability to swallow tablets or keep them down without vomiting) are unable to be treated with other medication.

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Alongside their use in pain management, opiate patches are most commonly used in the UK to treat individuals suffering from opioid use disorder (opioid addiction).

Use of Opiate Butrans Patches in Addiction Treatment

Opiate patches are considered to be very effective in the treatment of opioid addiction – which in the UK commonly manifests as an addiction to heroin, but also comprises addiction to other illegal opioids and to opioid painkillers which may be legally prescribed.

Most obviously, opiate patches prescribed by a doctor are a legal alternative to what are often highly illegal substances, aiming to remove the addict from criminality and the danger of serious legal repercussions; and are significantly safer and healthier than opioid abuse in the form of injecting, smoking, sorting or various other means of administration.

Opiate patches will not provide the same euphoric high as much opioid abuse; however, the administration of opioids by patches, and the regulated tapering down of dosages, make withdrawal a significantly less daunting prospect for anyone who has developed a dependence to opioids.

Opiate Butrans patches in opioid replacement therapy

Opiate patches can be prescribed to opioid addicts as a replacement for more dangerous and/or illegal opioids, making it easier to manage dosages and to taper down those dosages over time, and to reduce cravings and the severity of withdrawal syndrome. Although it is often a non – negotiable requirement to have completed the detox phase, some treatment facilities and organisations will provide therapy and other elements of a treatment programme to individuals who are using opiate patches. As these individuals are no longer engaging in substance abuse per se and are able to benefit from the therapy which may be provided them, certain rehabs are willing help them to work towards coming off their opiate patches in accordance with an agreed timeline.

Opiate Butrans patches in detoxification

One of the most challenging aspects of tackling an opioid addiction is detoxification, which is almost always accompanied by withdrawal. Someone who has developed a dependence to opioids may be prescribed opiate patches once withdrawal symptoms begin to manifest. Though it is important to note that each case of withdrawal is unique and there is no guarantee that opiate patches will have the same efficacy in every case, one or two patches applied during the withdrawal period can alleviate symptoms, and symptoms typically do not return at the end of that treatment period.

Adverse Effects of Unsupervised Opiate Butrans Patch Use

These patches can have adverse effects – which can be much more significant and severe if the use of opiate patches is not supervised by a doctor.

Respiratory Depression

Respiratory depression is, effectively, inadequate or insufficient breathing, causing an increased concentration of carbon dioxide in the blood (respiratory acidosis) which can be fatal. In some cases, respiratory depression can lead to respiratory arrest: the complete cessation of breathing and subsequent death due to a lack of oxygen.

Physical and Psychological Buprenorphine Dependence

Buprenorphine is potentially habit-forming, and the repeated use of opiate patches over time can lead to dependence and addiction. Individuals prescribed opiate patches as a treatment for opioid use disorder will presumably already have a dependence to opioids, but someone using them for pain relief or recreationally, who is not already dependent, runs the risk of becoming so.

Contraindications

Buprenorphine should not be prescribed to anyone suffering from any of the following conditions and issues:

  • hepatitis B or C
  • thyroid problems
  • psychosis
  • enlarged prostate
  • hypotension
  • cor pulmonale
  • liver problems
  • alcohol intoxication
  • issues affecting the gall bladder
  • an inability to empty the bladder
  • decreased lung function, including chronic obstructive pulmonary disease (COPD)

Precautions and Warnings

Opiate patches have been associated with an increased risk of:

  • neonatal opioid withdrawal syndrome
  • life-threatening respiratory depression (especially in patients with chronic pulmonary disease, and elderly, cachectic or debilitated patients)
  • adrenal insufficiency
  • severe hypotension
  • hepatotoxicity

Buprenorphine may be dangerous for patients with increased intracranial pressure, brain tumours, head injuries or impaired consciousness; and if used alongside benzodiazepines and/or other CNS depressants.

An allergic reaction to buprenorphine can be dangerous; contact emergency services immediately if you take buprenorphine via any means including a transdermal patch, and experience any of the following:

  • hives
  • difficulty breathing
  • swelling of the face, throat, lips or tongue
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Opiate Butrans Patch Mechanism of Addiction

Someone using opiate patches in accordance with a doctor’s instructions is unlikely to experience the euphoric high which drives much opioid abuse; however, if consumed in other ways (for example, chewing the patches – which can be extremely dangerous) or in higher quantities than prescribed it is possible to achieve a certain high.

Regardless of the high or lack thereof, however, the regular use of opiate patches over time is likely to lead to dependence and addiction in someone who is not already addicted to opioids. Physical dependence to buprenorphine can develop relatively quickly, and a psychological addiction even more so.

Common Warning Signs of Butrans Patch Abuse

It can be difficult to spot opiate patch abuse. However, the following signs may indicate opiate patch abuse:

  • increased tolerance
  • preoccupation with drugs
  • lying to gain more prescriptions
  • erratic behaviour
  • withdrawal symptoms

The Dangers of Butrans Patch Abuse

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Simply because opiate patches are a prescription medication does not mean that they are “safe”: opioids are strong and potentially dangerous drugs, and using opiate patches in any way other than in strict accordance with the instructions of your doctor can lead to catastrophe.

As well as the potential for dependence and addiction, abusing opiate patches (i.e. taking them in ways or in dosages other than those outlined by the prescribing physician) gives rise to the risk of overdose or other health risks related to the improper consumption of the buprenorphine extracted from a patch. Opiate patch abuse can also constitute illegal activity if you are in possession of opiate patches without a prescription.

Recognising a Butrans Patch Addiction

If you are using – or abusing – opiate patches, you are risk of developing dependence and addiction. If you find yourself doing or experiencing any of the following, you should contact your GP and/or an addiction specialist immediately:

  • wearing someone else’s patch
  • wearing more than one patch
  • wearing a patch at a higher dose than what you were prescribed
  • opening the patch to extract the liquid gel
  • dissolving the gel so you can snort or inject it directly into your bloodstream
  • buying opiate patches on the street or from those who have a running prescription
  • using a fake prescription to buy opiate patches
  • experiencing an intense craving for opiate patches
  • continued use, even when you recognise the negative effects it has on your relationships and general health
  • financial difficulties from funding opiate patch use
  • distortion in sleep patterns
  • lack of control over opiate patch use
  • failed attempts to quit opiate patch usage

Detox and Withdrawal from Butrans Patches

Although opiate patches are commonly used to assist with detoxification and withdrawal, a dependence and addiction to them will also require detox for treatment to be successful – and that detox is likely to lead to the manifestation of withdrawal syndrome. Because of the unpleasant nature of opioid withdrawal – and the serious psychological symptoms, including suicidal ideation – it is vital that you do not attempt detox without medical assistance. Contact your GP and/or an addiction specialist to discuss safe detox and withdrawal.

Intervention for Butrans Patch Addiction

If someone close to you is addicted to opiate patches, it is understandable that you may wish to take action to try to help them – perhaps by organising an intervention. However, it is possible to do more harm than good when attempting to assist an addict, and it is highly recommended that you do not attempt to intervene without getting professional advice. Contact an addiction specialist to discuss your situation and whether or not an intervention would be beneficial – and, if so, how best to effect it.

Importance of medically supervised use of opiate Butrans patches in addiction treatment

Opiate patches should only ever be used in accordance with the instructions of a doctor. If you are suffering from an opioid addiction, it is understandable that you may wish to tackle that addiction yourself, and you may be able to procure opiate patches independently (for example, by the dark web). However, opiates are strong drugs and come with various significant risks to physical and mental health. You should never attempt the unsupervised use of opiate patches: speak with your GP and/or an addiction specialist about the role opiate patches can play in your fight against addiction.

Opiate Butrans Patches Statistics

  • Approximately 34 million people around the world use opioids each year. Of those, some 27 million have an opioid use disorder.
  • Fewer than 10% of individuals in need of treatment for opioid addiction are receiving it.
  • Around the world, approximately 120,000 people die each year as a result of an opioid use disorder.
  • GPs prescribed just under 24 million opioid-based painkillers in England alone in 2017.
  • Buprenorphine was patented in 1965 and has been approved for medical use since 1981.

Ready to get help for your addiction?

If you are addicted to any opioids, opiate patches can play an extremely useful role in your recovery. Meanwhile, if you have developed an addiction to opiate patches themselves, there are other treatment options available. Either way, however, no treatment can be successful until and unless you are able to acknowledge your condition and ask for help. Get in touch with your GP and/or an addiction specialist as soon as possible to discuss your situation and find out how best to tackle your addiction; picking up that phone will be the first step on the road back to a happy, healthy life.

FAQ

Why do people abuse Butrans?
Some people abuse opiate patches in order to try to achieve a euphoric “high”; others because they have become addicted to opioids. Each person has their own reason why they engage in substance abuse; the one constant is that such abuse is dangerous for anyone and everyone.
What is the difference between Butrans patches and Suboxone?
Butrans is a brand name for buprenorphine; Suboxone is a brand name for the combination medication buprenorphine/naloxone.
Can I become addicted to Butrans?
Yes; like any opioids, opiate patches can be habit-forming.
What is the ‘high’ experience like when you use Butrans?
Used correctly, the high caused by opiate patches is negligible or non-existent.
why is this medication prescribed?
Opiate patches are prescribed for the treatment of chronic and acute pain, and opioid use disorder.
How should this medicine be used
Only ever use opiate patches in strict accordance with the instructions of your doctor.
What special precautions should I follow?
Opiate patches should not be used in certain circumstances, or by certain types of patient. Speak with the prescribing doctor about any risks posed by opiate patch use.
What special dietary instructions should I follow?
There are not usually any significant dietary effects of using opiate patches; if you have any specific dietary requirements or challenges, consult your GP about any risks.
What should I do if I forget a dose?
Opiate patches typically last for seven days; if you forget to replace your patch after that time, your medicine may become ineffective and withdrawal symptoms may manifest. Speak with your prescribing doctor if you have forgotten to replace your patch after its effective period.
What should I know about storage and disposal of this medication?
You should keep opiate patches – and any other opioids – secure and away from anyone else, especially children. Similarly, dispose of them securely: speak with your GP about how to get rid of unused opiate patches correctly.

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