Suboxone for Opiate Addiction

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How Suboxone Is Used to Help With Opiate Addiction

Opiate addiction is without a doubt one of the most difficult substance addictions to overcome. Doing so successfully requires dedication, persistence, support, and, most importantly, a true desire to change your lifestyle. However, anyone who’s struggling with opiate dependency should know that they don’t have to get through it alone. There are people, resources, and medications available to any person who’s serious about getting better. One medication that has proven to be effective for treating opiate addiction is Suboxone.

Why Are Medications Like Suboxone Necessary?

Treatments medications like Suboxone are necessary because of the many challenges that opiate dependence creates. In addition to suffering a variety of unpleasant physical withdrawal symptoms, many people also experience significant mental and emotional dependencies on opiates. Some of the most common symptoms of opiate withdrawal are anxiety, muscle aches, insomnia, cold sweats, restless leg syndrome, diarrhea, nausea, vomiting, and depression. When someone is dealing with many or all of these symptoms, it can be overwhelmingly difficult to start making positive life changes toward recovery. It can also be extremely difficult to resist the urge to use opiates simply to end the misery of withdrawal.

For these reasons, even if an opiate user has a strong desire to find recovery, it’s rarely as simple as just stopping their usage. A medication like Suboxone will remove the burden of some of the most challenging parts of getting past an opiate addiction. As a result, the person can focus on other parts of their recovery, such as adjusting to a new lifestyle and rebuilding certain aspects of their life.

What Is Suboxone?

Suboxone is an oral prescription drug that’s used as a maintenance medication for people working to overcome their opiate addictions. It was approved by the U.S. Food and Drug Administration in 2002 for that purpose. Suboxone contains two active medications: buprenorphine and naloxone.

Buprenorphine is a partial opioid antagonist and serves as the primary ingredient in Suboxone. Buprenorphine’s purpose within the drug is to prevent cravings and opiate withdrawal symptoms, which it accomplishes by blocking the opiate receptors in the brain.

Naloxone, on the other hand, is a full opioid antagonist. Its job within Suboxone is to prevent the effects of the opiates themselves. So, the two drugs in conjunction prevent you from suffering withdrawal symptoms or cravings and prevent you from feeling the “high” effects of opiates.

How Is Suboxone Prescribed?

Suboxone is generally prescribed as part of a structured plan for detoxification and, in many cases, maintenance therapy. It can be prescribed either in tablets or film strips, and it comes in a handful of different doses. The amount of buprenorphine per tablet or film may be 12, 8, 4, or 2 mg, and the amount of naloxone is always one-quarter the amount of buprenorphine.

Typically, Suboxone users will ingest one tablet or strip sublingually each day until they no longer need the medication to aid in their recoveries. The specific timeframe for taking Suboxone varies based on a number of factors, which we’ll cover a bit later on.

When Is Suboxone Usually Prescribed?

While Suboxone can be an incredibly helpful medication in the right context, it isn’t the be-all-end-all for curing opiate dependence. If someone is still actively abusing opiates, Suboxone won’t be much help to them. In fact, if you take regular opiates, such as oxycodone or hydrocodone, in conjunction with Suboxone, you may suffer from symptoms of precipitated withdrawal.

Typically, Suboxone is prescribed to people who have recently stopped their opiate usage and who wish to progress down the road of recovery. In most cases, doctors who prescribe the medication will talk extensively with the client before they prescribe it. Physicians do this so that they can determine whether or not the person is in a situation in which Suboxone is likely to truly help them. The fact is, if you aren’t genuinely ready to recover, Suboxone won’t be able to do much good.

Is Suboxone Effective for Opiate Addiction?

At this point, there is an abundance of evidence showing that Suboxone programs are effective treatment measures for recovering from opiate addiction. Although several types of medication can help with opioid addiction, Suboxone is unique in some ways. Primarily, Suboxone is unique because it combines three of the most important aspects of opiate recovery by removing the cravings, removing the withdrawal symptoms, and deterring current opiate usage.

In the majority of cases, Suboxone has been shown to be more effective when it’s taken for longer periods of time. For example, one study shows that opioid-addicted youth who took Suboxone for 12 weeks were more likely to remain abstinent than those who took it for only two weeks. Granted, every person and situation is different, and there’s no correct answer across the board for how long people should be prescribed the medication. More often than not, those with a long-term or more extreme opioid addiction are typically more likely to stay on Suboxone for a prolonged period.

How Does a Suboxone Treatment Plan Work?

Suboxone is not a medication that will typically be prescribed without a specific process and treatment plan. The treatment plan won’t be identical for every single person, but it will usually follow a relatively consistent structure. As a treatment plan proceeds, the prescribing doctor will usually evaluate how it’s going and whether or not it’s working as intended. If the person taking the medication is having trouble with the plan, the doctor may choose to change the approach.

Intake

The first step of any Suboxone treatment program will be the intake phase. During the intake stage, the doctor will evaluate the client to determine if a Suboxone prescription is the right choice for them. In most cases, this part of the process includes a full medical and psychosocial evaluation, a urine drug screen, and blood testing. This is how the doctor decides not just whether or not Suboxone will be able to help the person but also if they’ll be able to take the medication safely.

Induction

Typically, the induction phase of the process immediately follows the intake phase. This part of the treatment program is about transitioning the client from their current opiate usage to taking the Suboxone instead. The goal is to achieve a smooth transition without the person having to experience any of the unpleasant withdrawal symptoms. At this time, the client will take their first dose of the medication, and the doctor will monitor how they react to it.

Stabilization

After the person in recovery has had their first experience taking the Suboxone and has successfully transitioned from their previous opiate usage, the next phase is stabilization. During this crucial part of the process, the client and doctor work together to determine the appropriate daily dosage. The doctor will want to avoid prescribing a dose that’s either too high or too low. If the dosage is needlessly high, it will unnecessarily make it harder for the client to wean off the medication when the time comes. However, if the dosage is too low, it won’t effectively stave off the cravings and withdrawal symptoms.

For most doctors, the goal is to find that sweet spot. They want to prescribe the lowest possible dosage that will still serve as an effective treatment. In many cases, the ideal dosage will be determined over a brief period of trial and error.

Maintenance

The maintenance phase of Suboxone treatment is the part of the process in which the specifics vary the most. Every person in recovery has different needs, which means that maintenance will be a bit different for each unique situation. In some cases, the maintenance phase will be a prolonged process in which the client regularly checks in with their doctor to provide updates on their recovery. It’s also common for the maintenance stage to include attendance at a support group, such as Narcotics Anonymous.

When Does Suboxone Treatment for Opiate Addiction End?

There’s no one-size-fits-all timetable when it comes to Suboxone treatment for opiate addiction. With most doctors, the goal will be to have you only continue taking the medication for as long as you need it. However, it’s unlikely that they’ll ever try to force you off of it before you’re ready. Generally, determining the right time to wean off the medication requires the consideration of several factors.

The most important consideration is whether or not the person is mentally and emotionally ready to stop taking the medication. In many cases, people in recovery will attend some kind of therapy or support group to help them work through the issues tied up with their previous opiate usage. Usually, it’s best to wait until you feel like you’ve made real progress or even moved past those issues before removing the assistance of the Suboxone. Ideally, the choice to end the maintenance phase of treatment will be a joint decision between the doctor and the client.

In cases of severe or long-term opiate addiction, the timeframe for taking the medication will usually be significantly longer. For example, someone who was hooked on hydrocodone for a few months after having it prescribed for an injury may only need a few weeks of Suboxone usage to get over their dependence. Alternatively, someone who is recovering from a multi-year heroin or oxycodone addiction may need to stay on Suboxone for several months or even years. In some rare cases, people with the most persistent addictions will remain on the maintenance medication indefinitely.

How Does Someone Stop Taking Suboxone?

Although buprenorphine is not a full-blown opiate, those who take it can still develop a physical dependence on it. For this reason, the vast majority of people who have it prescribed will need to gradually wean off of it when they’re ready to stop. Ideally, this tapering process should be doctor assisted. Most of the time, it will involve several steps of slowly lowering the dose, until the daily dose is small enough that the person can safely stop using it. This can take anywhere from a week or two to several months, depending on the person and the doctor.

Other Suboxone Considerations

Anyone who takes Suboxone should be aware that it does sometimes result in certain adverse side effects. First and foremost, anyone with moderate to severe liver dysfunction should be especially cautious when taking the medication since it can lead to a worsening of those symptoms. Suboxone has also been known to cause constipation, headaches, nausea, vomiting, insomnia, excessive sweating, and accumulation of fluid in the legs.

Suboxone does have the potential to be misused, and it should only be taken under the supervision of a medical professional as part of a prescribed treatment or maintenance program.

If you’re dealing with a dependence on opiates or any other substance, remember that there are always people out there willing to help. Whether you realize it or not, many people genuinely care, and there are also many resources available to help you recover. If you have a true desire to improve your life and are willing to give it your all, there’s no reason that you can’t get on a path toward well-being. If you need help or are interested in learning more about recovery, contact your local rehab center. They will be able to provide you with information and resources to help steer you in the direction of full recovery.

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Reviewed By:

Dr. John Elgin Wilkaitis

Dr. John Elgin Wilkaitis completed medical school at The University of Mississippi Medical Center and residency in general psychiatry in 2003. He completed a fellowship in Child and Adolescent Psychiatry at Cincinnati Children’s Hospital in 2005. Following this, he served as Chief Medical Officer for 10 years of Brentwood Behavioral Healthcare a private health system including a 105-bed hospital, residential treatment, and intensive outpatient services.

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