Suboxone

Part of the complete guide to understanding addiction
Learn more about medication assisted treatment

What Is Suboxone?

Suboxone is a prescription brand name drug made up of buprenorphine and naloxone that treats opiate addiction and dependence.

Buprenorphine (Belbuca, Probuphine, Buprenex) is used to treat Opioid Use Disorder (OUD), as well as acute and chronic pain. It is known to be the first drug to treat OUD.

Naloxone (Narcan) is an FDA-approved medication created to reverse the effect of an opioid overdose. It can easily be administered via a prefilled syringe or nasal spray. As a result, everyday citizens are able to carry and administer naloxone to individuals suspected of overdosing on opioids.

Learn more about Narcan

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History of Suboxone

In 1966, Buprenorphine was created to treat pain. The standard medical way to treat pain was via morphine; however, as we know, morphine is extremely addictive and has dangerous side effects. The goal of creating Buprenorphine was to achieve the pain-relieving effects without the harmful side effects.

Researchers heavily tested buprenorphine in clinical trials, and the correlation of being able to use buprenorphine as a treatment for opiate addiction was soon linked. When the medication was released in 1995, concerns quickly arose about buprenorphine’s addictive qualities.

After some time, the National Institute of Drug Abuse (NIDA) spearheaded the creation of Suboxone which features both buprenorphine and Naloxone. The goal of this combination drug was to make buprenorphine less addictive — balancing out its impact as naloxone binds to opioid receptors counteracting the craving effect of opiates.

Additionally, naloxone is often used as an emergency drug during an opiate overdose due to this mechanism of action. Suboxone carries an important role in the route to the treatment of narcotic addiction.

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How Is Suboxone Used?

Suboxone comes in the form of a dissolvable oral film or a tablet. The film can be placed under the tongue or between the gums and cheek, while the tablet can only be placed under the tongue (sublingual) to dissolve.

The drug works by binding to the same receptors that opiates bind to in the brain. Replacing the opiate with suboxone on those receptors helps regulate the user’s brain chemistry.

The drug comes in four different dosages, each stage helping the addicted individual wean themselves off of their dependence. A common issue when it comes to helping individuals with opiate addiction is keeping them to a consistent treatment plan. The way that suboxone effectiveness as a treatment for opioid dependence is tracked is based on how long individuals stay on the treatment.

For the proper treatment of opioid dependence, the drug must be used in tandem with counseling and behavioral therapy. When Suboxone is used in a treatment plan, it can successfully terminate opioid cravings.

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Is Suboxone Safe To Use?

The drug is classified as a Schedule III Controlled Substance which means it is safe to use a medical drug under the guidance of a licensed physician. Doctors who are allowed to prescribe this medication have undergone specific training and certification. That being said, the drug may cause dependence issues and can be misused.

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What Dosage Of Suboxone Is Appropriate?

When it comes to your physician deciding what dosage is appropriate to prescribe, there are several factors to look at. These include the individual’s overall health, what medical conditions they have, what type and how severe their opioid addiction is, and what stage they are in their treatment.

Typically, a physician will start by prescribing a patient Suboxone at a low dose which they will go ahead and adjust over time. The goal is often to prescribe a low dose that can provide the desired impact.

This first phase of drug prescription is called the “induction phase,” during which the doctor’s goal is to use Suboxone to reduce the symptoms of withdrawal from stopping or reducing opioid use. Shortly afterward, the patient moves into the “maintenance phase” where Suboxone is used at a stable dosage over a set time. The drug at this phase is mainly used to keep the cravings for opioid use or withdrawal symptoms in check as an individual goes through a treatment program.

Suboxone should be taken every day at the same time to create a proper regimen and ensure maximum efficacy. It is important to advise new users that it often takes from 30 to 60 minutes for Suboxone to begin to work.

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Suboxone Side Effects

Suboxone does not come without side effects. There are side effects that are mild and more common, and those that are more serious. If you or someone you know is having serious side effects, talk to a physician or get immediate help if the situation feels life-threatening.

Some examples of common side effects include:

• Headache
• Nausea
• Sweating
• Anxiety
• Depression
• Constipation
• Insomnia
• Symptoms related to opiate withdrawal (e.g., aches, cramps, rapid heart rate)

These side effects tend to resolve on their own over a few days to weeks after usage ends.

Some examples of serious side effects include:

• Coma
• Drug abuse or dependence (long term use side effect)
• Liver Damage (long term use side effect)
• Withdrawal symptoms are severe
• Severe allergic reaction
• Hormone Issues (long term use side effects)

These side effects tend to be more serious and may not resolve as easily; medical intervention may be needed in some instances.

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Can You Overdose On Suboxone?

It is possible to overdose on Suboxone when the medication is misused, and too high of a dose is taken. However, it is more difficult to overdose on Suboxone because the drug has a limit on how many opioid receptors it can activate simultaneously.

The danger of overdose on Suboxone increases when individuals mix the drug with other medications that are sedatives, such as a benzodiazepine.

Some key signs to look out for in a potential overdose include:

• Slow or no breathing
• Pinpoint pupils
• Severe drowsiness
• Vomiting
• Decreased touch sensation

If you suspect someone has overdosed on suboxone, call 911 immediately.

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Suboxone Withdrawal

Suboxone is generally taken for long periods to help ease the dependency on opiates of those struggling with addiction. With this knowledge, we can understand that when an individual stops taking Suboxone “cold turkey” after using the medication for some time, there will be a withdrawal period. It is advised to follow a physician’s instructions when a patient is weaning themselves off of Suboxone to prevent suboxone withdrawal.

Symptoms of withdrawal are the worst within the first 72 hours, as during this time, many of the physical symptoms will be heightened. These symptoms can include muscle aches and cold-like symptoms.

After one week, an individual may experience mood swings, anxiety, and restlessness. Two weeks out is when depression hits. A month out there will be symptoms of opioid cravings, discomfort, and depression.

Learn more about withdrawal

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What Are The Alternatives?

Suboxone is not the only form of therapy, although it is one of the most effective forms. You can use other methods to help an individual dealing with opioid addiction or overdose; however, a physician would be best suited to find which method is the best route to help.

Here are alternatives to Suboxone:

• Buprenorphine
• Buprenorphine and Naloxone
• Methadone
• Naltrexone
• Lofexidine
• Bunavail
• Zubsolv
• Narcan (used in emergency opioid overdose situations)

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Assistance With Addiction Treatment

There is currently a major push from doctors and medical staff to push for fewer restrictions in prescribing Suboxone to patients, especially in the current opioid crisis we are experiencing. With its notable efficacy and the promise it holds in helping to wean people off of opiates Suboxone has the potential to save countless lives if utilized properly.

To find a Suboxone clinic near you, visit the Substance Abuse and Mental Health Administration’s (SAMHSA) website. Additionally, if you live in California, Michigan, or New Jersey, visit WorkIt Health for further resources and guidance for the treatment of opioid dependence or find a rehab center near you.

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