Long Term Suboxone® Use – What If I’m on Suboxone for the Rest of My Life?

Addiction to opioids and heroin is nothing new, but some of the ways we treat it are. In the past, methadone was the standard medication used to help people abusing opiates stay sober, but this came with significant downsides. Methadone still produces a powerful high, and users began to abuse it in the same way that they abused opiates in the past. Methadone also carries a higher risk of overdose, and therapeutic outcomes were hampered by the fact that people who need methadone can only get it in specific types of clinics — and are typically only able to take the drug under clinical supervision.

Still, medication-assisted treatment (MAT) has been shown to improve outcomes for some people in recovery from opioid addiction, and after some period of time, an option appeared that carried a moderately lower risk and could be prescribed from a doctor’s office: Suboxone®. For the last decade, Suboxone® has largely replaced methadone as the standard for this type of MAT, providing a safer, more convenient way to get relief during detox and beyond.

It may seem like a miracle drug for some people, but others are still skeptical. In this piece, we’ll be discussing some concerns that users have about Suboxone® and other buprenorphine treatment , and importantly, talking about the consequences of long-term Suboxone® use.

Why Are People Concerned About “A Life on Suboxone”?

The long-term effects of taking Suboxone® are not established in any consensus. After all, it’s still relatively new in the complete history of addiction treatment. Many in the treatment community believe that Suboxone® is safe for long-term use, but there’s a central conflict with this line of thinking that sparks fear in people considering a medication-assisted treatment. What happens if you can’t get off Suboxone®?

What Is Suboxone®?

Suboxone is the brand name medication consisting of a combination of two chemicals: buprenorphine and naloxone. The ingredient that makes Suboxone® so widely used in treatment is buprenorphine, a partial opioid agonist. This means that it bonds to some of the same receptors in the brain as more addictive opioids. Importantly, however, the receptors that are most strongly linked to the intense euphoria one gets when using prescription opioids, heroin or morphine are left alone by buprenorphine. This means that the high users get from Suboxone is much less intense the high they’d get from other, similar substances.

The other half of the combination in Suboxone® is naloxone, an opioid antagonist. The product is now only available in the medium of film strips. In 2011 the tablet format of Suboxone® was discontinued due to concerns for abuse. What this means is that Suboxone cannot be taken through injection — which would, in theory, produce the strongest effects of the drug — without feeling intense withdrawal symptoms. Furthermore Naloxone may interfere w/ the desired high from abusing the medication.

What Is Suboxone Used For?

In the recovery community, Suboxone® may be viewed controversially. Many people say that sobriety cannot be achieved without complete abstinence from drugs, but it’s hard to argue against some of the uses that Suboxone® has for people in recovery from opioids. It has short-term and long-term applications:

• In the short term, Suboxone® can help during detox as a way to replace the input of stronger opioids and decrease the negative symptoms of opioid withdrawal.
• In its long-term use, Suboxone® can replace other opioids completely. Some users stay on Suboxone® for many years because of its potential to help prevent relapse. But the latter seems to be the source of a lot of concern.

Trouble Getting Off Suboxone®

As it turns out, this is a valid fear. While a weaker variety, buprenorphine is an opioid and a controlled substance. While it has a low potential for full-blown addiction, it still carries a risk of addiction and abuse.

Some people argue that it’s perfectly fine to stay on the low dose of buprenorphine provided by Suboxone® for a longer duration — potentially even for a lifetime. Opponents point to a different side effect of long-term Suboxone use: Once a person stops using Suboxone, studies show that they are at an increased risk for relapse.

Stopping buprenorphine is also accompanied by withdrawal of its own, which may make it more difficult to stop using Suboxone®. Suboxone withdrawal may cause insomnia, anxiety, depression, headaches, fever and a range of other unpleasant symptoms. This increases the odds that a person who tries to quit using Suboxone may return to using other opioids to ease withdrawal symptoms.

What Does a Plan to Get Off Suboxone Look Like?

Whether you’re using it currently or considering seeking it to support your journey to recovery from opioid addiction, it’s important to be prepared for the long-term effects of Suboxone® use. One of those is opioid dependence, which makes the way you choose to stop using Suboxone important.

Experts recommend tapering, a practice that involves gradually reducing the amount of Suboxone you take over the course of a few weeks. This will give you a chance to get clean slowly, minimize potential withdrawal symptoms and, some studies suggest, lower your risk for using more addictive opiates once your system is rid of the buprenorphine. Fortunately the medication comes in various levels of strength from 12mg to 2mg, allowing for a slow wean.

The best way to get off Suboxone® is to consult with a specialist in addiction medicine, MAT and the key factors related to recovery from opioid addiction.

A Life Without Suboxone® Is Within Your Reach

One of the main arguments opponents of MAT during a treatment plan have is the viewpoint that as long as you’re using a substance as a crutch in your recovery, you’ll never truly be able to put addiction behind you. It’s true that taking Suboxone® for a long time isn’t necessarily conducive to full recovery, and there’s evidence to show that Suboxone® could put you at risk for relapse if you tried to quit without a support plan.

On the other hand, this viewpoint is exceptionally inflexible, a hallmark of the abstinence-only treatment model that’s being cast aside in favor of less rigid harm-reduction models. The point is that you should be able to control when you use a substance for its benefits and when you stop. If you’re using Suboxone, you may have already found that it’s more difficult to stop than you were led to believe when it was prescribed. We can help.

To learn about all your options in treatment for opioid addiction, contact FHE Health today.