How Do People Abuse Butrans? | Recreational Use

Butrans is a prescription pain medication that comes in a patch worn on the skin. It’s designed to slowly release buprenorphine over seven days to treat severe, chronic pain and help with opioid withdrawal symptoms. While Butrans helps many people manage pain safely when used correctly, it’s classified as a Schedule III controlled substance because it has potential for abuse and addiction.

Abusing Butrans is dangerous because people find ways to get more of the drug into their system faster than intended. Common methods of abuse include wearing multiple patches at the same time to increase the dose, chewing or swallowing patches to release all the medication at once, cutting open patches to extract the liquid gel inside, and then either injecting or snorting that liquid for an immediate high. These methods bypass the patch’s controlled-release design and flood the body with dangerous amounts of buprenorphine, which can lead to overdose, respiratory failure, and death.

Learn more about using Butrans patches to help with opioid withdrawal

Why Do People Abuse Butrans?

Many people abuse Butrans because it can generate an “upper” effect and euphoria. However, this euphoria is usually short-lived and mild. For some, the Butrans may be taking too long to work or the effects aren’t strong enough to treat the pain they’re feeling. In this case, the best option would be to contact the prescribing physician and discuss a dose adjustment.

But when taking matters into their own hands, a person may chew or extract the contents of the patch and administer it intravenously or intranasally to feel greater effects.

Read more about the euphoric effects of Butrans

Abusing Butrans Through Injection

One study from the National Center of Biotechnology Information (NCBI) found that the intravenous (IV) route of administering Butrans results in the strongest effect. Those who abuse Butrans through injection extract buprenorphine from the Butrans patch, then inject the liquid directly into the bloodstream. This is the most common form of Butrans abuse, and the most dangerous.

According to a 2009 study on buprenorphine toxicity and overdose, recent injection sites were found in over half of buprenorphine-related fatalities.

Abusing Butrans Through Snorting

People abuse Butrans through snorting similarly to abusing Butrans through injection. With snorting, a person extracts the liquid from the Butrans patch and snorts it into the nose. This form of Butrans abuse is much less common, though it can happen.

Abusing Butrans Through Chewing/Eating

Some people may also abuse Butrans by chewing or eating the entire patch. Chewing or eating Butrans patches can be extremely toxic and dangerous for physical and emotional health. It can cause choking, overdose, and death.

Consuming this much Butrans at once will release an uncontrollable amount of buprenorphine, which can be potentially life-threatening.

Read more about eating/chewing a Butrans patch

Abusing Butrans By Wearing Multiple Patches

Wearing more than one Butrans patch can cause stronger effects than if just one is worn. Only one Butrans patch should be worn at once unless directed otherwise by a medical professional. However, buprenorphine has a ceiling effect, so once a certain level of the medication has been absorbed into the body, the effects do not increase as the dose is increased.

Medical professionals strongly advise against wearing multiple Butrans patches because this can lead to a much higher absorption of buprenorphine into the body than a person can handle.

Risks Of Abusing Butrans

One of the most painful consequences of Butrans abuse is the withdrawal that happens when someone stops using or can’t access the drug. When a person regularly takes high doses of Butrans, their body becomes physically dependent on buprenorphine to function normally. The brain adjusts its chemistry to compensate for the constant presence of the opioid. Once Butrans is removed from the system whether by choice, running out of supply, or being cut off by a doctor, the body goes into shock trying to readjust.

Common withdrawal symptoms from Butrans abuse include:

• Severe Abdominal Cramping and Digestive Distress: painful stomach cramps, nausea, vomiting, and diarrhea that can last for days and lead to dehydration
• Fever and Chills: body temperature swings where the person alternates between burning up with fever and experiencing cold sweats and uncontrollable shivering
• Flu-Like Symptoms: runny nose, watery eyes, sneezing, and congestion that mimic a severe cold or flu
• Intense Anxiety and Panic: overwhelming feelings of worry, fear, and impending doom that can trigger panic attacks
• Extreme Nervousness and Agitation: feeling on edge, irritable, and unable to calm down or relax
• Physical Restlessness: inability to sit still, constant fidgeting, leg movements, and feeling like you need to keep moving even when exhausted
• Muscle and Bone Pain: deep, aching pain throughout the body that makes every movement uncomfortable
• Insomnia and Sleep Disturbances: complete inability to fall asleep or stay asleep despite exhaustion
• Depression and Mood Swings: intense sadness, hopelessness, and rapid emotional changes

These withdrawal symptoms typically begin within 12-48 hours after the last dose and can last anywhere from several days to several weeks depending on how heavily someone abused Butrans. The severity of withdrawal often drives people back to using, creating a vicious cycle of abuse that’s extremely difficult to break without professional help.

Increased Chance Of Developing An Addiction

Abusing Butrans by chewing, snorting, injecting, or otherwise tampering with the medication may also lead to an addiction. Whether the opioid was obtained through a prescription or illicitly, Butrans has the potential for misuse. Butrans can also lead to an addiction even if appropriate dosing was used.

Manipulating the medication on a partial or regular basis can quickly lead to an addiction as the body becomes more and more used to being supplied with those chemicals. Recreationally abusing Butrans can lead to a long-term addiction that will likely require treatment such as therapy, detox, and other methods of coming off the substance.

Risk Of Overdose

Because of the ceiling effect of Butrans, a person may not realize how much of the opioid is in their body. This increases the risk of overdose on Butrans. While research has yet to determine a lethal dose of buprenorphine, studies have found that there have been numerous buprenorphine-related overdose deaths.

These deaths do not usually occur from buprenorphine abuse alone. Most of those cases involve mixing buprenorphine with benzodiazepines (benzos).

Possibility Of Death

Recreationally abusing Butrans can cause major respiratory depression, which can result in death. Researchers have also suggested that using Butrans and benzodiazepines can result in a synergistic depressant effect of the two drugs. Abusing Butrans by injecting, snorting, or chewing the medication can enhance the effects of the drug and create a very dangerous environment when benzos are mixed in.

This can lead to life-threatening complications such as:

• coma
• severe sedation
• respiratory depression
• death

Find Butrans Treatment For Opioid Abuse

If you or someone you know if battling opioid abuse, help is available. Browse our directory or reach out to Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about recovery services, including medication-assisted treatment.

Written by the Addiction Resource Editorial Staff