Buprenorphine is a partial opioid agonist, meaning that it acts on certain opioid receptors in the brain, providing potent relief from pain, cravings, and opioid withdrawal symptoms, while acting as an antagonist on other opioid receptors. Buprenorphine has a "ceiling effect" on respiration: Increasingly higher doses do not decrease breathing to the same extent that other opioids do. Deaths due to buprenorphine overdoses are rare and usually involve multiple medications (e.g., benzodiazepines, alcohol, other opioids) or intravenous use.
Buprenorphine is a potent pain reliever with advantages for patients with chronic pain or pain complicated by OUD. Any provider licensed by the DEA (e.g., physician, nurse practitioner, physician assistant, midwife, clinical pharmacist) can prescribe buprenorphine for pain without a DEA waiver. The DEA clarified that "limitations and requirements [relating to addiction treatment] in no way impact the ability of a practitioner to utilize opioids for the treatment of pain when acting in the usual course of medical practice. Consequently, when it is necessary to discontinue a pain patient's opioid analgesic therapy by tapering or weaning doses, there are no restrictions with respect to the drugs that may be used. This is not considered detoxification as it is applied to addiction treatment. If the target condition is pain, then buprenorphine can be compounded by a compounding pharmacy to create low doses, or low doses of the buccal and patch formulations can be used. Buprenorphine in formulations for pain cannot be used for patients with addiction and without a pain diagnosis due to FDA restrictions. .
Buprenorphine provides excellent pain control. It has an excellent safety profile due to a ceiling effect on respiratory suppression (meaning higher doses will not stop breathing and only rarely cause overdose). Buprenorphine's onset of action is 30 to 60 minutes, and it typically provides eight hours of pain relief, so it is usually given in divided doses when used for pain unless the patch formulation is used. Like any opioid, buprenorphine should be used sparingly, and only when the benefit outweighs the risk.
Buprenorphine can be a safer analgesic choice than other opioids for:
Patients dependent on long-term opioids for pain, especially for those either experiencing negative effects from long-term opioid use or taking opioids at potentially unsafe doses.
Unlike other long-acting opioids, buprenorphine has relatively few drug/drug interactions and does not accumulate in patients with renal impairment. Due to long half-life, partial agonist activity at the mu receptor, and antagonism at the kappa receptor, common medical problems resulting from other long- acting opioids arise less frequently with buprenorphine. These problems include sleep apnea, low testosterone, sexual dysfunction, osteopenia, opioid-induced hyperalgesia, mood disorders (depression and anxiety), and dysregulation of the hypothalamic pituitary adrenal axis. A growing body of literature shows improved pain relief on buprenorphine after conversion from other long-acting opioids.
For elderly patients using long-term opioids, transitioning to buprenorphine lowers the risk of accidental overdose and potentially lowers the risk of medical complications (e.g., sleep apnea and hypogonadism). For this reason, buprenorphine may be a safer choice for elderly patients already on daily opioid treatment.
We have several ways of dealing with chronic pain. We use trigger point injections or PRP (platelet rich plasma). But sometimes when you are dealing with chronic pain, you need medication to manage your pain on a daily basis. There are several option of medications that are available. After a complete medical evaluation with Dr. Cerre, he can direct your care for your pain relief needs. His goal is for you to experience Extraordinary Pain Relief!
For patients that are NOT currently on pain medication, we can evaluate and treat your pain. If your pain is not managed after receiving other treatment from our office, we can help you with a Pain Medication Program.
If you are currently on pain medications, we focus on those patients that are on Buprenorphine or certain opiates used for chronic pain relief only. We DO NOT treat patients that have been treated for addiction or want to be treated for addiction. We accept patients that are currently on Buprenorphine or other opiate pain medication such as Norco or hydrocodone.
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Dr. Eric Cerre is a Naturopathic Medical Physician focusing on male enhancement, erectile dysfunction, Peyronie's Disease, male hormone replacement as well as treatment of acute and chronic pain condition with PRP and Exosomes. Practicing medicine for over 34 years, Dr. Cerre has treated thousands of patients and is one of the first providers of the P-Sot and 0-Shot in Arizona. He is also a Shockwave provider. Dr. Cerre only uses the highest quality, FDA- approved medical devices such as the Magellan, TruPRP Machine and kits, to treat these conditions.
Our number one priority is in providing relief for our patients and our payment structure is designed to support our philosophy.
We have largely structured our services for the patient who is seeking pain relief and resolution without strict limitations and boundaries imposed by insurance plans.
Have questions about cost and paying for your treatment?