• Suboxone: Buprenorphine and Naloxone
• Hooked on Suboxone
• Suboxone Detox and Further Treatment
You've heard of drugs like heroin and morphine. As narcotics, they are helpful and infamous for causing a brief burst of euphoria, followed by powerfully drowsy and lethargic feelings in their users.
This can be very addictive, but simply discontinuing consumption of an addictive substance is much easier said than done. That's why certain drugs are made and licensed to help wean patients off the more complex imports they're on, but even these come with their risks. In the case of opioid dependence, Suboxone is a popular choice of detox drug and poses its caveats.
Suboxone: Buprenorphine and Naloxone
SUBOXONE Film is used as part of a medical, social and psychological treatment program for patients dependent on opioids like heroin, morphine, oxycodone or codeine. SUBOXONE Film is used to help such patients to regain control over their lives
When we say “Suboxone,” we're talking about two drugs that are combined: buprenorphine and naloxone.
Buprenorphine is a partial opioid antagonist. This implies that it can cause impacts like other narcotics (it binds to the same receptors in the brain as heroin and methadone do), but not to the same extent. The euphoria is less pronounced and not as habit-forming (it takes between 24 and 60 hours for the body to get rid of half a dose of buprenorphine, according to the Substance Abuse and Mental Health Services Administration); therefore, there is a lower potential for abuse, and the withdrawal effects are relatively milder compared to those of other opioids like heroin.
For this reason, buprenorphine is used to help wean addicts off their current opioid dependency by providing them with a less harmful alternative. However, there is still an element of risk involved in downgrading a patient to a drug that they may consider safer, which is why the other ingredient of Suboxone is naloxone.
Naloxone is a narcotic, but unlike buprenorphine being a partial opioid antagonist, naloxone is a pure opioid antagonist. This means that it undoes the effects of other narcotics. But there is a reason heroin addicts are not simply prescribed a course of naloxone: the reversal effects can be so acute that patients can experience severe withdrawal symptoms that cannot be easily controlled. These may include:
• Rapid heart rate
• Nausea and vomiting
For that reason, the naloxone is bundled with buprenorphine: to simultaneously rewrite the drug-addled brain's connections while providing a safety net of gradually diminishing narcotic boosts. Put together; the two drugs become Suboxone.
Hooked on Suboxone
Suboxone enjoys popularity as an opioid addiction treatment. Still, even regular doses can become habit-forming, especially in patients whose dependence on narcotics has left them particularly vulnerable to any opioid influence.
There is an intrinsic risk in giving a patient addicted to substance-related, similar drugs to treat the addiction. Opiate dependence is so strong and powerful that the safest option for these patients is to let them down gently, diluting craving to the point where they have the strength and resources to deal with them.
A writer on The Fix said he had to take Suboxone to get off heroin initially; then, he became hooked on the Suboxone. The writer mentions an article from Village Voice that asks if Suboxone is a “wonder drug” that genuinely helps heroin addicts get clean or if it's just another way for people to get high. New York City's Special Narcotics Prosecutor tells Village Voice that addicts purchase Suboxone when their drug of choice is too expensive or when they have to appear sober (one person who claimed to be a “professional, honest guy” with a family begged for Suboxone because he wanted to get off his drug habit without the withdrawal symptoms preventing him from working). While online sellers make a fortune by claiming to sell Suboxone to heroin addicts who want to kick their habit, the prosecutor says that the Suboxone trade is actually about managing a pre-existing addiction.
A former heroin addict and current intervention specialist confirms to Village Voice that patients are very likely to continue furthering their dependence on narcotics without actual treatment. There's even a term for going back and forth between the drug of choice and the drug that you use to control your habit: “bridging.” A substance abuse counsellor clarifies that a patient taking Suboxone independently, without medical supervision, has no idea whether the drug is doing any good.
This led the writer of The Fix article to seek out Suboxone to treat his heroin problem. After attempting methadone, Suboxone seemed like a good alternative for averting what he called “the Sickness,” the withdrawal symptoms of physical addiction. But eight years after successfully putting his heroin habit behind him, he still has to take Suboxone, being told that less than two per cent of the people who take Suboxone eventually get off the drug. The feeling that the illness is at the door, waiting to sweep in as soon as the Suboxone is gone, is overwhelming. The writer compares being on Suboxone to being like a heroin user again, only without the high.
It may sound dramatic, but Kentucky's Courier-Journal carries the story of a young man who resorted to dangerous methods to get more out of his Suboxone prescription after the medication helped him get over his addiction to OxyContin. When he started to acclimatise to the supposedly safer high of Suboxone, he began to dissolve the Suboxone strips he was prescribed in water, then shot the resultant mixture into his veins. That's because “Suboxone addiction is huge,” in the words of the president of a treatment centre. However, breaking or crushing a Suboxone tablet to snort the powder, or dissolving it in a liquid to inject into the veins, can be fatal.
Adverse Effects (brutal )
Profiling the “blockbuster drug” with a dark side, The New York Times wrote of the case of a 20-year-old man who died after overdosing on Suboxone given to him by a friend who, now serving 71 months of a federal prison sentence, didn't know it was possible to overdose on Suboxone. The Times analysed national data and found that Suboxone was a “primary drug” in 420 deaths reported to the U.S. Food and Drug Administration since 2003.
A young man who finally broke free of his Suboxone dependence described the process to Village Voice as “brutal,” claiming that while it probably protected him from overdosing on heroin, it didn't address the underlying addiction issues. The withdrawal issues brought about by the Suboxone itself.
These withdrawal effects may include:
• Nausea and vomiting
• Muscle aches and cramps
• Abdominal pain and diarrhoea
• Irritability and agitation
• Craving for more Suboxone
• Depression and anxiety
The severity of Suboxone withdrawal symptoms can depend on several factors: how long the patient has been taking Suboxone; their previous drug and medical history; how long since their last intake of Suboxone, and the dosage thereof (Suboxone generally stays in the body for about 37 hours); whether the withdrawal effects are the result of tapering off, or an attempt to quit “cold turkey”; and whether they are other opioid drugs at play.
Those factors may also determine how long the detoxification process takes. Detoxification is a careful, overseen process where the patient is gradually denied access to the drug they were misusing to let her body heal from the damage caused by the drug. This process should be carried out in a hospital or treatment facility, so that trained staff members can be on hand to supply the appropriate anti-anxiety or anticonvulsant medication to help carry the patient through the inevitable withdrawal (for example, benzodiazepines are often used to help people through the stages of alcohol detoxification).
Suboxone Detox and Further Treatment
Since this detoxification will certainly trigger withdrawal effects, this step must be conducted in a treatment facility in the presence of healthcare professionals. Those who attempt to detox on their own risk relapsing into more profound drug use when the withdrawal effects become intolerable.
Detoxing early and under the purview of a rehabilitation facility can reduce the process's length and make it relatively more bearable for everyone involved. The Fix explains that detoxification puts an addict (and their family) through an emotional and psychological wringer, but this is necessary to move the patient past the stage where he feels an overwhelming need to satisfy the body's cravings. Depending on the addict, his drug history and the depth of his addiction, Suboxone detoxification can take any length of the period from one week to a month.
But as Suboxone users who found themselves replacing their heroin addiction with a Suboxone one find out, going clean means going deep. Whenever the detoxification process is complete (Mental Health Daily suggests waiting 90 days to ensure that the withdrawal symptoms have indeed diminished), the patient can begin drug counselling. She works with a psychologist to address the issues that led her to her opioid dependence in the first place. Simply overcoming the physical temptation to use again is only half the job, as the user will more than likely fall back into her destructive habits when confronted with temptation, stress, boredom, isolation, or merely the opportunity to use Suboxone again.
That's why WebMD says that counselling is a vital component of treating drug addiction. There are many other factors at play behind addiction, and detoxification addresses only half of them. The other half is covered by working with a trained therapist who can help the patient understand how and why behind the addiction and learn different ways to cope with the myriad ways that Suboxone once seemed like a good idea.
Prescription drug dependence can be especially devastating because the supposed promise of help and recovery instead becomes a new source of fear, craving, and misery. At FRN, we're here to guide you through the process of emerging from the shadow of a Suboxone addiction. We have admissions coordinators who can answer your questions about Suboxone, heroin, narcotics and opioids, and work with you on starting a treatment plan. If you have questions or concerns about Suboxone, whether for yourself or someone you know, please call us today, and we can work together on finding a truly permanent and lasting solution.
Therapy and Aftercare Support
Therapy, says WebMD, is not an option for recovering from a substance abuse problem; it's a requirement. It is where recovering addicts learn how they can repair their lives following the devastation of Suboxone addiction, learning what keys unlocked the issues in their lives that lead them to abuse Suboxone, and understanding how they can thrive daily without the need for drugs.
A good treatment centre will give recovering addicts a setting where their bodies and minds can be rehabilitated in tranquillity and safety.
The Fix explains that this could take anywhere from one month to six months. Still, in such an environment, clients are taught how to heal, forgive themselves, protect themselves against relapse, and learn from (and with) others who found themselves in the same predicament.
When clients are ready, they can be discharged from treatment, but they must get in touch with a 12-Step group or an aftercare support program, like an alumni treatment program. Such networks will help clients maintain the concepts and protocols of treatment in everyday life's grind and stress. The challenge of maintaining abstinence in the face of the natural world can be overwhelming for those who once gave in to Suboxone cravings. Learning how to say no, recognise the triggers of relapse, and pick themselves up again in the event of a deterioration make the discrepancy between continued recovery and starting from scratch. For that reason, aftercare groups are essential parts of the treatment paradigm.
Suboxone is one of the most abused prescription drugs globally. In the words of the Courier-Journal, it is indeed a cruel irony that a miracle drug to treat opioid abuse can become a source of opioid abuse itself.
People who have developed an addiction to Suboxone have recovered; they have improved their lives; and they have walked away from treatment healthy, optimistic, and hopeful.
Ben Lesser is one of the most sought-after experts in health, fitness and medicine. His articles impress with unique research work as well as field-tested skills. He is a freelance medical writer specializing in creating content to improve public awareness of health topics. We are honored to have Ben writing exclusively for Dualdiagnosis.org.