There is consistent evidence supporting the effectiveness of buprenorphine as a pain medication with greater tolerability relative to other opioids. This evidence base suggests that buprenorphine is a well-tolerated and appropriate option for long-term opioid therapy among individuals living with chronic pain. A review study looking at the conversion to buprenorphine from other opioids for chronic pain showed that most studies reported improved pain outcomes after conversion from other opioids to buprenorphine. A meta-analysis of published studies demonstrates that the degree of pain relief can vary depending on whether an individual has comorbid OUD, with more pain relief experienced among individuals without OUD compared to individuals with OUD. This finding suggests greater complexity in managing chronic pain among individuals with OUD and underscores the importance of a multimodal approach to pain management within this population.

In addition to pain improvements, buprenorphine is found to be associated with improvements in quality of life relative to other opioids. Evidence shows that conversion to buprenorphine from opioids was found to be associated with increased self-reported quality of life, which was greater among those with higher pre-conversion opioid doses. It is hypothesized that the quality of life improvement is precipitated by a reduction in pain interference in daily activities.

Buprenorphine for chronic pain has the potential to decrease total opioid burden as measured by daily use of morphine. In one study, findings show that 24% of participants who were on buprenorphine lowered their total opioid intake over the total study duration. In another study looking at individuals with chronic pain who converted from opioids to buprenorphine, an 85% reduction in total opioid intake was observed, driven by a decreased usage of opioids for breakthrough pain among the total cohort. These studies need to be interpreted carefully, as conversion methodologies for buprenorphine can vary due to unique opioid receptor binding properties compared to other opioids. Most recently, another study found an insignificant decrease in total opioid intake among individuals who switched to buprenorphine relative to those who did not, but findings were limited, likely due to low intervention penetration among the buprenorphine group.