[lwptoc] Medications like Suboxone (buprenorphine and naloxone) are a crucial part of any opioid detox program. Your doctor is in charge of prescribing the medication and if you’re looking for more information you’ve come to the right place.
In this guide, we want to get you the most accurate information and answer as many questions you have about overcoming addiction.
We’ve divided it up into 5 major sections:
- What is Suboxone? In-depth information about the medication and how it works vs other treatments.
- Suboxone Withdrawals. Important data on withdrawal symptoms and Suboxone detox.
- Programs for opioid addiction. 12 step programs and other support systems that will help keep you on the right path.
- Signs of Addiction in a loved one. Become more aware of a loved one struggling and get them the help they need help.
- Frequently Asked Questions. Answers to the most relevant questions about Suboxone and opioid treatment.
Are you or a loved one battling addiction? Find out how Compass Detox can help by contacting us today.
What is Suboxone (buprenorphine and naloxone)?
Heroin and other opioids are classified as full opioid agonists. They bind to opioid receptors, causing an intense “rush” for a short while with potential deadly effects over time.
Some major side effects of opioids include:
- Clouded mental function
- Respiratory distress
- Death in some cases
Over time the body becomes accustomed to exogenous opioids and users need more to get “high”, increasing the chance of possible overdose. It changes the chemistry in the brain and their body becomes reliant on the drug to stabilize, This dependency triggers intense withdrawal symptoms, especially for long term users. They lose the ability to be happy without it. It takes over their thoughts and actions become obsessed with finding more, often at the expense of their relationships, careers, and in some cases, their lives.
While it may not be not deadly, acute withdrawal symptoms may require hospitalization. Treatment for withdrawal includes Suboxone. Suboxone was designed as a non-intoxicating treatment to opioid addiction. Taken sublingually, the pill dissolves on your tongue. It combines 2 opioid medications – Buprenorphine (partial opioid agonist) and Naloxone (full opioid antagonist).
Buprenorphine only partially binds to your opioid receptors, triggering them slightly (similar, in effect, to methadone). Reducing urges without the euphoric effect. At the same time it stops other opioids from binding to them taking away any incentive/ability to pursue a high. Naloxone(Narcan) is an opioid receptor blocker, included to discourage abuse of Buprenorphine.
When ingested, the Naloxone in Suboxone has a negligible effect. If injected or snorted, it will induce opioid withdrawal, immediately. Don’t misuse any medications.
Buprenorphine is a long-acting medication, lasting up to 3 days. It starts working 30 to 45 minutes after ingested and provides stable, mild stimulation of the opioid receptors, preventing withdrawals and intense cravings in a highly tolerable way. This can help reduce the risk of relapse. By itself it’s used as a pain reliever, mainly in Europe.
Side by side comparisons
Let’s take a look at how Suboxone compares with other methods of opioid-addiction treatment. Be sure to ask your doctor if you feel like it’s right for you.
Suboxone was developed as a response to misuse of other medications, to mitigate the issues associated with the other treatments. It should be used in conjunction with a comprehensive drug treatment program.
Suboxone vs Methadone
Since 1947, Methadone was widely used to wean users off opioids. Once seen as the most effective treatments, misuse became more prevalent over time, and some wanted to explore other options. Medical researchers began thinking of alternative treatments. So in 2002, Suboxone was created and was toted as an alternative to methadone, with less likelihood for abuse.
Ease of access
Suboxone can be prescribed by most medical doctors, while Methadone must be prescribed by a specialist.
With Suboxone, 49% of users reported reduced abuse of prescription pain killers, according to drugfree.org. With Methadone, studies have shown 33% fewer opioid positive drug tests and 4.44 times more likely to stick with treatment according to drugabuse.gov.
It has been suggested that Suboxone is about 6 times safer than Methadone. This is likely because of the added Naloxone.
Suboxone vs Subutex
Subutex is the brand name of buprenorphine, the main difference is no added Naloxone. Since they use the same active ingredient, effectiveness is the same compared to Suboxone. Suboxone is significantly less likely to be abused and therefore a smarter choice for someone with severe opioid addiction.
Suboxone Treatment Uses
It’s prescribed as a safer alternative to Methadone. It can help with opioid or heroin addiction. It lessens the withdrawal effects of opioids and has slight pain-killing effects to more easily manage symptoms.
How to use Suboxone
Please, only use as prescribed by your doctor. Your doctor knows your case and unique situation. His/her advice supersedes any advice given in this article.
Suboxone comes as a peach-colored hexagonal pill or as a generic oral film. It is a sublingual medication, taken under the tongue and allowed to dissolve. Many different types of medicine are taken this way to help them absorb into the body quicker.
It’s a more direct route to the bloodstream without having to travel through the digestive tract. This method also makes the medicine more potent, increasing its efficacy. It’s the most efficient way, especially for people that have trouble swallowing pills.
Make sure your hands are dry when using Suboxone to avoid absorption through the skin.
Suboxone comes in multiple strengths-
- 2 mg buprenorphine / 0.5 mg naloxone
- 4 mg buprenorphine / 1 mg naloxone
- 8 mg buprenorphine / 2 mg naloxone
- 12 mg buprenorphine / 3 mg naloxone
At a ratio of 4 (Buprenorphine) to 1 (Naloxone). Your doctor will give you a specific prescription based on your case.
Possible Suboxone (buprenorphine and naloxone) Side Effects
There are important side effects to note when taking any prescription medication. Talk to your doctor if you are experiencing any acute symptoms as they might be signs of a more serious condition.
- Respiratory issues: Respiratory depression is a common problem with opioids. One of the more severe side effects. The breathing can become shallow or slow down significantly. This could cause a lack of oxygen in the body and can result in death.
- Burning tongue
- Irritated mouth
- Lower sex hormones
Suboxone and Drug Tests
It is a Schedule III prescription drug and a controlled substance. It does not show up on a standard drug test and won’t cause false positives. Buprenorphine is a drug similar to other opioids but has a different chemical make-up. Additionally, the drug breaks down into its unique metabolites. It shouldn’t show up unless specifically tested for.
Though, it’s primarily used for opioid addiction, it is still technically a partial opioid. It will cause physical and psychological dependence in many cases. Quitting Suboxone cold turkey, without a doctors advice is never recommended. A Suboxone detox, in small declining increments is the typical strategy. Many of the withdrawal symptoms are the same as opioid withdrawal, you’re still dependent on them as you’re tapering off. The most effective way is to wean you off over a few weeks or months, while keeping you functional in society until eventually, you become completely independent of the drug.
The onset of Suboxone withdrawals generally begin 1 to 3 days after your last dose. This is considerably longer than other opioids because of its long-lasting properties. Longer effects mean withdrawals appear at a lengthier timetable. This is confusing for some because they can go days feeling fine then be in full withdrawal seemingly out of nowhere.
Most physical symptoms will peak around 3 to 5 days, and can last for about 2 weeks. After this, they mostly subdue. During this time, you’ll need to be closely monitored by a doctor to ensure there are no complications. It’s important to be in a safe, clean environment.
Physical symptoms include:
- Stomach pain
- Liver damage
Psychological & Emotional Withdrawal
The psychological effects tend to last longer than the physical. Long-term addicts can feel the effects of opioid withdrawal for months, and in severe cases for years.
Inability to experience pleasure is common for previous addicts. This is because the euphoria from opioids has compromised the bodies ability to produce it, potentially causing long term damage.
- Mood swings
These are the main symptoms. People can experience these to varying degrees. Some people may not experience any at all and others may experience some of them. Many don’t require extra hospitalization. Some additional side effects might not be on this list so it’s important to discuss all potential side effects with your doctor.
Steps to help with Suboxone Detox
Your Suboxone detox will be primarily managed by your physician. For some it’s an easy process. For others it can be quite hard to move past, so a doctor managing it in real-time is the number one way to improve chances of success.
- Drink lots of water
Hydration is key, when detoxing as it helps your body get back to a point of homeostasis. Most of us don’t drink enough water as is. With the addition of your internal battle against withdrawal it’s more important than ever.
- Eat healthy, nutrient-rich foods
During this period, you body can lose a lot of nutrients. To heal and rebound more quickly, your body needs the resources to recover. Like a construction company, you can only build a house with the right materials.
- Meditation for anxiety
Many addicts who have previously beat their opioid addictions have used meditation as a form of added treatment. To read more on the benefits of meditation, visit Healthline’s article on the 12 science-based benefits of meditation.
- Therapy/support group
Whether a recovering addict is in-patient or or outpatient, having access to a support group is crucial on their road to recovery.
High doses of the medication have some serious side effects. Since it’s an opioid-based medication, symptoms with misuse can become lethal. They include:
- Keep all your drugs in a safe place and out of reach of children or pets.
- Safety of use during pregnancy is determined by your doctor as long-term use can cause withdrawal symptoms in the fetus once born and can be deadly.
- Do not take unless prescribed by your doctor
- Misuse can lead to adverse, irreversible side effects, including death if you overdose.
- Seek medical attention right away if you pass out, experience dizziness or extreme drowsiness. These might be signs of an overdose.
- Do not use with alcohol
- Read all the side effects and instructions given to you by your pharmacist
Many doctors recommend a slow tapering off of Suboxone, reducing your daily intake is one of the most effective ways you can prevent a relapse.
Let your doctor know if you:
- Have ever had an allergic reaction to Buprenorphine
- Have liver disease or a heart condition
- Have asthma or other respiratory issues
- Are taking other medications
- Are pregnant or breastfeeding
- Are taking blood pressure medication
- Have any other medical conditions
Your doctor needs as much information as possible to prescribe the correct dosage. At the end of the day, it’s up to you to make him/her aware of your medical history and any concerns you have.
Note: Grapefruit can increase the negative side effects of the drug. Reduce or stop the consumption of grapefruit during use.
Suboxone detox verse other opioids
Detox from Suboxone is usually milder than a full opioid but this isn’t always the case. As the weaning process goes on and you use less and less every month/week the symptoms will mitigate but the mental addiction might last for a lot longer.
Finding the Right Support System
Often, medications are necessary, but the right support system will help you stay on track. Though this may be a lifelong battle, it gets easier over time. Some of the reasons an addict might relapse is that we have no one to turn to, something happens in our lives or the nights become unbearable. Being able to talk to other people who’ve been through it and come out the other end may just be that help you need to make it through. A great support group can be anything from professional support groups like NA to a smaller group of other addicts who have also experienced addiction and recovery.
12 step programs are highly effective in fighting addiction. It’s about facing certain truths and beating the demons the plague our existence. A recovering addict finds a sponsor in the NA meetings to help guide them through the 12 steps.
Here are the 12 steps of Narcotics Anonymous (NA):
- Step 1: We admitted we were powerless over our addiction, that our lives had become unmanageable.
- Step 2: We came to believe that a Power greater than ourselves could restore us to sanity.
- Step 3: We made a decision to turn our will and our lives over to the care of God as we understood Him.
- Step 4: We made a searching and fearless moral inventory of ourselves.
- Step 5: We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Step 6: We were entirely ready to have God remove all these defects of character.
- Step 7: We humbly asked Him to remove our shortcomings.
- Step 8: We made a list of all persons we had harmed, and became willing to make amends to them all.
- Step 9: We made direct amends to such people wherever possible, except when to do so would injure them or others.
- Step 10: We continued to take personal inventory and when we were wrong promptly admitted it.
- Step 11: We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Step 12: Having had a spiritual awakening as the result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.
Narcotics Anonymous was designed to created to help addicts fight their addictions. We can’t do it on our own and shouldn’t have to. NA is worldwide and in every major US city. It a community that promotes healing and a return to a happy & healthy life. Narcotics anonymous also offers virtual meetings, because they know how important treatment is to you. You’re never alone.
Read more about NA and find local Narcotics Anonymous meetings at na.org.
Is someone you love in trouble?
A loved one that’s struggling with addiction can be heartbreaking. To avoid detection many users will lie and try to hide use from their friends and family. Some get very good at hiding their drug use activity from those they love. Here are some things to look for if you suspect someone might have an opioid addiction:
Frequent drowsiness or flu-like symptoms
By itself this isn’t an indicator of addiction but together with other behaviors this can be disconcerting, especially if they’re generally healthy. This might be an indicator of opioid misuse or alcohol addiction as well.
Difficulty managing cravings
If a loved one is having trouble controlling their cravings for their pain medication, it would be good to keep an eye on their usage. As usage goes up, the body becomes dependent and needs more to get high. If they’re running out of their prescription early every month, they’re taking more than the recommended dose. If they’re finding it from elicit sources, it’s gotten to a bad point and will affect other areas of their life.
As dependency takes over, it seems more important to addicts than almost anything else. They will shirk responsibilities from child care and appointments to their career. An intervention can be necessary at this point to make sure they’re not throwing their life away to get high.
Once an addiction drains someone financially, if they are deep into it they’ll look for other ways to get the drug. This can be as simple as borrowing money but once that runs out some resort to stealing. At this point, major action must be taken.
Many users in an attempt to hide the habit will lie about usage and their whereabouts. Most are poorly thought out and to a sober mind, just don’t add up. To their altered mind it makes sense and they want to put the issue to bed quickly without answering many questions. The more questions you ask the more likely it is to find a hole in their story.
General lethargy and lack of hygiene
Opioid abuse will be most prevalent when they’re coming down. Those experiencing withdrawals will generally be depressed and not take care of themselves. Their body can’t produce the chemicals to make them happy and it beats them down as long as the symptoms persist.
Addiction is a terrible trap people get sucked in to but we must be aware of it happening, whether it’s us or someone we care deeply about. It’s a terrible disease that we must be willing to combat. This means not looking the other way when they’re hurting. It means being empathetic and collaborative during recovery.
It’s these time’s where a good support system is very important, because they’re at their most vulnerable. It is a war that America and the world as a whole have been fighting for a while but we are incredibly resilient and can beat this.
With the proper treatment with medications like Suboxone and a plan for success laid out by a doctor, we can and will beat addiction. Some of us need help along the way and there is absolutely no shame in that. So fight together, make the world better, and don’t give up on the people you love.
Yes, though not in the traditional sense of the word. Buprenorphine is a partial opioid agonist. Binding to opioid receptors in the brain and preventing other opioids from binding to them.
Suboxone has a very weak effect compared to full opioids. It provides slight pain-killing effects and decreases withdrawal symptoms. Since it’s only a partial agonist it also has a “ceiling effect” where the effects plateau after a certain point.
24 to 60 hours. It varies based on metabolism, weight, and other factors. Full opioids (like Oxycodone, Percocet, and Morphine) will have zero effects but if you continue to use more you can still overdose. This study by Johns Hopkins University goes into more detail.
On average, once under the tongue it takes about 4 to 8 minutes to completely disintegrate.
Any sedatives, antidepressants, or sleeping medications are strongly discouraged when taking Suboxone.
Cost varies based on individual cases and needs. Lower doses cost around $5 so a treatment regimen can be as little as $59 or up to $220.
Yes. Unfortunately, addiction is only mitigated through this process. Withdrawal is a common occurrence. Reported by most users over the long term.
The Suboxone alcohol interaction can potentially be fatal. Drinking alcohol on Suboxone is not recommended. It can amplify the negative effects and cause severe breathing issues. Also, loss of consciousness or coma can occur.
Do you have an opioid dependence?
Typically people go in for a surgery or other procedure and afterward a prescribed pain medication. This can be in the form of Percocet, Oxycodone, or even Morphine.
Many people, through no fault of their own, develop a dependency to these opioids. As time goes by they require more and more of the drug to feel the same euphoric effect it started as. As usage goes up, it becomes a dark rabbit hole of dependency. Some will try to quit cold turkey, withdrawals become harsh, both physically and mentally making it very hard to quit.
The difficulty is reflected in this sobering fact- According to the CDC, in 2018 alone, over 70% of drug overdoes involved a prescription of illicit opioid. Opioid addiction can be very difficult to beat and the doctor might prescribe medication to mitigate the symptoms.
If you or a loved one are currently battling addiction, there is help! Find out more and verify insurance coverage by contacting Compass Detox, a drug & alcohol detox center based in south Florida.