Suboxone is the prescription name of a medication containing buprenorphine (an opioid) and naloxone (an opiate blocker), which is frequently used for the detoxification of a patient from opiates, and also for the long-term maintenance of a sustainable lifestyle. It is prescribed by a doctor and comes in the form of a thin dissolvable strip or pill taken orally. The pill or strip is placed under the tongue to be absorbed. This method is called ‘sublingually’ (under the tongue). It works by tapering a patient off of opiates in a controlled, monitored setting to minimize the symptoms of withdrawal. It contains a mild opioid, which although is usually a minute portion compared to normal levels an addict would be taking, it can under the right circumstances produce a similar effect to that of a mild painkiller. No other opiates can be consumed while on suboxone because of the active ingredient naloxone, used to reverse the effects of an opioid, such as in the nasal spray Narcan, which is used for the emergency treatment of overdoses. Suboxone can only be prescribed by a doctor and should always be taken with medical supervision under the care of a professional.
How is Suboxone Distributed?
Suboxone is distributed as individually packaged strips that usually come in prescriptions pertinent to the length of the expected detoxification process. In the case of long-term suboxone maintenance (Medication Assisted Treatment – MAT), suboxone can be distributed in weekly or monthly amounts, always in prepackaged strips to be imbibed on a daily basis. Someone who is addicted to opiates has likely found out (usually the hard way) that once you stop taking opiates, after a period of daily using, withdrawal symptoms will start to take effect. This can be intensified based on the amount of substance being used, the length of time, and the brevity in which the substance stops being taken. For example, if someone uses a gram of heroin intravenously every day for a year, and then on day 366 takes nothing, they are going to be vomiting, shivering, sweating, and having diarrhea, sometimes all at the same time, whereas someone taking Percocet 5mg, twice a day for two weeks, will probably have trouble sleeping and may get night sweats or a decreased appetite. The medical need for Suboxone treatment is determined by a doctor but the idea is to taper one off so as to reduce these symptoms.
Buprenorphine is one of the two active ingredients in Suboxone and is a mild opioid, which can produce similar effects to that of opiates such as oxycodone or heroin when taken in extreme amounts. The active amount of buprenorphine is minute, relative to the amount an addict would be taking to get high and therefore simply reduces the feelings of sickness that come from abruptly halting an opiate dependence. Subutex, which is often misconceived as being interchangeable with Suboxone, also contains buprenorphine but is missing a key ingredient: naloxone. Naloxone is an opiate agonist. It is used in Narcan nasal spray, known for its ability to bring someone back from the brink of death after an opiate overdose. Naloxone can reverse the effects of opiates and is the second active ingredient in Suboxone.
Once an individual has imbibed Suboxone and therefore naloxone, its ingredients serve to block the effects of any opiates that one might ingest, accidentally or intentionally. An individual cannot take Suboxone while on using an opiate, without entering into a state of precipitated withdrawal. This means that all the symptoms listed formerly, such as vomiting diarrhea, night sweats, etc., will immediately manifest. This catapults the patient into a much worse state of well-being then they were, no matter how bad they were feeling previously, resulting in hospitalization in extreme cases. It is recommended that someone who is need of Suboxone receives their first prescribed dose 24 hours after their last opiate use. Suboxone treatment involves using suboxone as a taper for a temporary time to wean someone off of opiates. In the world of drug treatment, it is not uncommon to see someone make attempt after attempt at lasting sobriety and end in failure, overdose, and not seldom enough – death. Because of this, patients can have the option of long-term suboxone “maintenance” which involves a highly supervised, daily dose of suboxone which can enable one to function on a daily basis without resorting to using heroin, or whatever their opiate drug of choice may be. The goal of this is to eventually maintain long-term, permanent abstinence of all substances, but for many people, six months of taking suboxone could mean six months without overdosing and can help ease the minds of families and loved ones while the patient continues progressing in their lives.
Suboxone contains the opioid buprenorphine, which although is administered in a minute amount can still produce a similar effect to that of stronger opiates if taken after a period of abstinence. This is often common in a jail setting, in which a building is filled with addicts, who don’t have access to the drugs they were addicted to and therefore have low enough tolerances where the small amount of buprenorphine in a Suboxone can produce a euphoric effect. Buprenorphine, like all opioids, can be physically addictive and therefore can come with a withdrawal period. Suboxone withdrawal is much different from heroin because it is under the close supervision of a medical professional. Suboxone is administered in strips in increments of 2mg up to 12mg at a time. Wherever one starts on suboxone they would eventually be dropped to progressively lower amounts until when finally ready to stop altogether, the daily amount being taken is so small that the withdrawal symptoms are very manageable. It is not uncommon to be prescribed other non-narcotic support medications to help with the symptoms of this milder withdrawal such as restlessness, fatigue, or nausea.
Can You Take Suboxone with Other Drugs?
Suboxone is a medication used in the treatment of opiate/opioid addiction; the goal of which is to ease the symptoms of withdrawal in a patient thus preventing them from getting “dope sick”. Because Suboxone contains an opioid, it is, in fact, possible to obtain a similar pleasant feeling to that of a stronger opiate/opioid while taking it. The dose, however, is usually such a small amount relative to the amount that a typical addict would be taking, that it simply prevents one from feeling withdrawal without actually giving a high. Suboxone is a Schedule III narcotic drug and thus can only be prescribed by a doctor. These doctors typically are available at most treatment centers but often have their own clinics, where they prescribe Suboxone to people in need.
Dangers of Suboxone
While Suboxone has saved thousands of lives and helps people every day avoid overdosing, it is still very controversial in the recovery community. The fact that it keeps people off worse drugs, helps withdrawal symptoms, and can prevent overdosing is great, but in the end, it is still an addictive drug. And an addictive opiate at that. Some people may take suboxone for years at a time and cannot get off because of the withdrawal symptoms. Weaning off suboxone slowly seems like a straightforward process but in reality, it is very difficult. There are still painful withdrawal symptoms. Many people in recovery believe that using suboxone is simply trading one drug for another. They don’t consider using suboxone as being sober and therefore believe it is only part of the problem. Many people believe that a long-term residential treatment program with complete sobriety is the only way to achieve true recovery. They believe that a treatment program helps change a person’s mind, body and spirit, which is necessary for a life transformation away from drugs. Still, it is hard to argue against suboxone for people who have tried treatment and still cannot stay sober. The fact that people can take suboxone, avoid overdosing, and avoid using street drugs, seems like a step in the right direction.
Whether or not you agree with suboxone is up to you. If you are considering it for yourself or for a loved one, you can reach out to the Florida House to get all your questions answered. Suboxone can be a great option for some people. It really just depends on your current situation, and past experiences. We have compassionate counselors available to speak to you.