Center for Medical Ethics and Health Policy Staff Publications
Publication Date
5-13-2024
Journal
Pharmacy
DOI
10.3390/pharmacy12030078
PMID
38804470
PMCID
PMC11130940
PubMedCentral® Posted Date
5-13-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
no
Keywords
buprenorphine, palliative care, cancer pain, pain, pain management, analgesics, narcotics, partial mu-opioid receptor
Abstract
Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, available formulations, drug–drug interactions, initiation and conversion strategies, and identifies ideal populations for use, especially within the palliative care patient population.