OxyContin pills arranged for a photo at a pharmacy in...

OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. Credit: AP / Toby Talbot

The opioid (narcotic) epidemic is a topic of national conversation and concern. While it is a conversation we as a country need to have, it is also important to focus on treating addiction and abuse in a way that still allows for the treatment of patients with legitimate chronic pain.

According to the National Center for Complementary and Integrative Health, 25.3 million adults suffer from chronic pain, and this number is expected to rise as baby boomers begin to age beyond 65 years. A solution needs to be found that does not increase the number of those suffering from opioid addiction and abuse, while still effectively treating chronic pain.

Last October, President Trump declared the opioid crisis a national health emergency and dispatched a team of specialists to outline effective strategies the government can take in treating the opioid crisis. In response, relevant companies and Congress have taken action; one pharmacy chain announced a policy that limits opioid prescriptions to seven days for certain acute prescriptions, and Congress passed the 21st Century Cures Act and the Comprehensive Addiction Recovery Act. Yet, in all these conversations there is a question that remains unanswered, “How can we treat those in pain and still stop the opioid epidemic?”

The government has identified buprenorphine as a key component in treating the opioid emergency. The Substance Abuse and Mental Health Services Administration (SAMHSA) has identified Medication-Assisted Treatments (MATs) as one of the most effective forms of treatment for opioid addiction. SAMHSA has outlined three MATs including buprenorphine, methadone and naltrexone. While these drugs are opioid based, it is important to note that buprenorphine’s effects on brain and lung function are significantly different from other pain medications.

Buprenorphine is different from other treatments because it is a partial agonist, meaning it does not completely bind to the opioid receptors in the brain, compared with more addictive drugs. By partly binding to these receptors, buprenorphine allows for those struggling with addiction to go through a less painful withdrawal process. Also, during the recovery process, craving for opioids is effectively controlled, and patients are often amazed and very grateful for this treatment and the healthy way they feel. It produces less side-effects than other opioids.

Buprenorphine has what doctors have termed as a “ceiling effect.” Meaning that after a certain dose of buprenorphine, there will be less impact on brain or respiratory functions, decreasing the risk of overdose and death.

Buprenorphine is classified as a Schedule III drug by the Drug Enforcement Agency while oxycodone, hydrocodone, morphine, fentanyl, methadone and hydromorphone are classified as Schedule II. Schedule III drugs are considered to be less abusable and addictive than Schedule II drugs, which are more commonly prescribed by doctors. As buprenorphine is not only safe and carries less risk for addiction and abuse compared to Schedule II products, it is also a proven and effective method of treating chronic pain.

Belbuca is an approved treatment for chronic pain and consists of buprenorphine and has been scientifically proven to treat pain effectively. Belbuca’s advanced delivery method is through a small dissolvable film that is placed on the inside of a patient’s mouth. Belbuca was developed with the intention to treat those living with chronic pain while decreasing the risk of addiction and abuse, making it a viable part of the solution to treating chronic pain while helping to curb the opioid crisis.

While we need to end the national health emergency, we must remember the millions of Americans suffering from chronic pain. In an opioid panel discussion at the Edward Kennedy Institute, Senator Sheldon Whitehouse of Rhode Island stated that “we cannot swing the pendulum too far to one side where people are dying in excruciating pain.”

This why buprenorphine is an important pain treatment option, in terms of both curbing the opioid crisis and continuing effective treatment of those suffering from chronic pain.

Noor Gajraj is the medical director of North Texas Center for Pain Management. He wrote this for InsideSources.com.

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