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Suboxone is a medication that combines buprenorphine and naloxone. It is used to treat dependence on and addiction to opiates, including heroin and narcotic painkillers. Buprenorphine is a partial agonist-antagonist, meaning that it mimics some of the effects of opioid drugs, while naloxone is an opioid antagonist, which means it blocks the effects of opiates. Buprenorphine reduces withdrawal symptoms and prevents cravings, while naloxone prevents the buprenorphine – as well as any other opiate – from causing the “high,” or rush of euphoria, associated with illicit drug use.
Suboxone can be a very useful tool in the opiate addiction recovery process, and many people use this medication for a short time, or even long-term, with no complications. However, Suboxone does have limited abuse potential and may itself become addictive, particularly if used incorrectly.
Suboxone is meant to replace the drug of abuse, but should be used in small doses and on a regular schedule, with the dosages eventually tapered over time. Dependence on Suboxone can lead some people to attempt to abuse the medication by taking larger doses or using it too frequently. Occasionally, an individual can become addicted to Suboxone. In this case, treatment is needed to address the addiction.
Suboxone is a carefully controlled substance. Only doctors certified to offer Suboxone can prescribe this medication. Often, it is dispensed directly from a medical office in order to discourage abuse of the drug. However, Suboxone is sometimes purchased as a “street drug” through illicit means. Individuals may also attempt to acquire additional Suboxone by claiming to have misplaced prescriptions or by visiting more than one doctor.
Even when used correctly, Suboxone can have unintended side effects. Abusing Suboxone, or mixing it with other substances, can exacerbate side effects or cause more serious effects to occur. Common side effects of Suboxone, according to the National Library of Medicine, include:
Some people do not react well to Suboxone. High doses of the drug can trigger more serious symptoms that require medical attention. These can include:
Very large doses of Suboxone can lead to an overdose, which occurs when the body cannot process the amount of the substance that’s been used. Symptoms of overdose include:
Not everyone who uses Suboxone on a long-term basis is addicted to the drug. In fact, when used as prescribed and under medical supervision, Suboxone does not generally lead to addiction.
Many people recovering from an addiction to other opiates use Suboxone as a maintenance medication and taper their dosage as they are able to, without triggering a relapse into illicit drug use. Addiction occurs when an individual compulsively seeks out and uses Suboxone regardless of negative life consequences that result from such use. When used correctly, Suboxone should improve life circumstances, rather than causing additional struggles.
Treatment for addiction to Suboxone typically begins with detox. This is the process of processing all addictive substances, such as drugs and alcohol, out of the body. In an individual has become physically dependent on Suboxone, the person will experience withdrawal symptoms when stopping use of the drug.
According to an article published in the Indian Journal of Psychiatry, buprenorphine withdrawal syndrome is similar to that experienced when stopping use of morphine and similar opiates. While the specific withdrawal timeline will vary according to each individual, withdrawal symptoms typically appear within two days of stopping drug use, and symptoms last up to 10 days. As a result, most medical detox programs last 5-10 days. Medical detox programs are meant to facilitate the withdrawal process within a supervised, supportive environment, in which clients can receive medications, supportive care, and complementary therapies as needed.
The first symptoms of opiate withdrawal to appear typically include:
After a few days, other symptoms may appear. These include:
The particular withdrawal symptoms experience during Suboxone detox will vary between individuals. The severity and duration of symptoms will depend on various factors, such as an individual’s physical composition, the presence of any co-occurring medical or mental health issues, and the person’s history of addiction treatment. The extent of the drug use influences the severity of the symptoms as well; more extensive past use of Suboxone will lead to a more severe withdrawal syndrome.
Detox from opiates and opioid agonist medications like Suboxone typically employs the use of medications. Suboxone itself is often used to treat addiction to other opiates, because it attaches to the same receptors within the brain, thereby mimicking the effects of other opioid drugs. But when Suboxone is the drug of abuse, other approaches must be used in the detox process.
One of the most commonly used medications in opiate withdrawal is clonidine. Clonidine primarily treats high blood pressure, which can occur when in withdrawal. This medication can also reduce anxiety, agitation, muscle aches, sweating, runny nose, and muscle cramping. Clonidine can reduce symptoms of withdrawal, but it does not prevent drug cravings. Other medications typically used to treat opiate withdrawal, like methadone, can reduce cravings, but may not be recommended when in recovery from Suboxone addiction, due to the potential for abuse.