Suboxone® is a prescription medication that is used for opioid withdrawal and opioid use disorder treatment. Suboxone is one of the medicines used in medication-assisted treatment (MAT). This treatment approach has been around for decades and uses prescription medications to help wean clients off of an addictive substance such as alcohol or opioids. Research has shown that Suboxone MAT decreases mortality rates, reduces incarceration and improves relapse rates. The FDA approved Suboxone in 2002 for the sole purpose of treating opioid use disorder. Opioids are painkillers that are incredibly addicting and can often result in lethal overdoses. Opioid withdrawal, although not life-threatening, can be incredibly uncomfortable. As a result, medications are needed to ease these withdrawal symptoms.
Suboxone Use Disorder
Suboxone not only acts to reduce opioid cravings but also helps to suppress the symptoms of withdrawal. Suboxone is used in medical settings to help you or your loved one stop using opioids, complete treatment and remain in recovery. Suboxone is a critical player in helping curb the current opioid epidemic; however, because Suboxone contains an opioid-like ingredient, it is often abused, resulting in Suboxone use disorder.
- In 2017, Suboxone exceeded commonly prescribed drugs such Viagra® and Adderall® in sales.
- There was a tenfold increase in the number of emergency room visits for buprenorphine medications. More than half of those 30,000 hospitalizations in one year were due to the non-medical use of the drug according to SAMHSA.
What is Suboxone?
Suboxone is a combination of buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, meaning that it acts similarly to opioids, without the life-threatening side effects. Just like pure opioids, partial opioid agonists do have a euphoric high and as a result, can be habit-forming, leading to Suboxone use disorder. If an individual is in opioid treatment and is taking Suboxone correctly, they will not endure uncomfortable opioid withdrawals because of the effects of buprenorphine.
Suboxone treatment can be short-term or long-term, depending on the individual. Some individuals will stay on Suboxone treatment for years, while others may only need Suboxone treatment for a couple of months. Naloxone is an opioid antagonist, meaning it blocks the effects of opioids, producing sudden withdrawal symptoms. If an individual takes an opioid such as Vicodin® or Percocet® while they are taking Suboxone, they will immediately undergo opioid withdrawals because of the effects of naloxone. Naloxone is supposed to encourage the individual to avoid opioids while in treatment.
Is Suboxone Addictive?
A problem with treating opioid use disorder with Suboxone is that the patient may still crave opioids and may never stop using Suboxone. Although Suboxone use disorder is not as bad as opioid use disorder, this can again create problems in multiple aspects of your life, including your personal and professional life. Suboxone can be abused by either taking too much at once or by altering the medication in ways that make naloxone ineffective. Suboxone is sold on the street for a very high value and has become a popular drug of abuse. Common street names for Suboxone include stops, boxes, sobos and stop signs.
Signs and Symptoms of Suboxone Intoxication
- Poor coordination
- Problems concentrating
- Extreme itching
- Shallow breathing
- Loss of appetite
Because Suboxone contains buprenorphine, a partial opioid agonist, there is potential for withdrawal symptoms if you stop taking Suboxone. Suboxone withdrawal symptoms are not as severe as pure opioid withdrawal symptoms. However, they can still be uncomfortable enough to want to use opioids to prevent further withdrawals. Significant withdrawal symptoms are at the highest between 24–48 hours after the last dose of Suboxone and subside after about a week.
Seeking Help for Suboxone Use Disorder
Suboxone use disorder, like heroin and other opioid use disorders, can threaten your family, job and financial success. If you are abusing Suboxone, you are at an increased risk for abusing pure opioids in the future, which could cost you your life. Seeking professional help for your Suboxone use disorder can potentially save your life and put you on the road to a successful and healthy recovery. Seek treatment if you have the following signs of Suboxone use disorder:
- Lying to your doctors to get Suboxone
- Doctor shopping to get extra Suboxone
- Using pure opioids while taking Suboxone
- Buying Suboxone on the street
- Forging or stealing Suboxone prescriptions
- Experiencing withdrawal symptoms in the absence of Suboxone
- Inability to stop taking Suboxone despite wanting to cut back
- Hiding your suboxone use disorder from friends, family and coworkers
- Requiring more Suboxone to feel the same euphoric high (tolerance)
- Stealing money or depleting your bank account to buy Suboxone
- Strained/broken relationships
- A decline in work or school performance
Suboxone Use Disorder Treatment
Similar to opioid abuse, individuals who are addicted to Suboxone are highly encouraged to undergo professional treatment. Whether it is residential treatment or outpatient treatment, the individual will initially have to undergo detoxification. The withdrawal process can be intense, and therefore medically supervised detoxification is always advisable. Opioids can be given to ease the withdrawal side effects associated with Suboxone withdrawal. The treatment team will discuss whether it is best to use Suboxone as a long-term treatment after detoxification is complete or to switch to another medication. Methadone and naltrexone are appropriate alternatives for Suboxone to prevent withdrawal symptoms and future cravings.
Psychotherapy is also encouraged to help uncover the underlying triggers that drove the individual to abuse opioids or Suboxone. Whether it is past trauma, an undiagnosed mental health disorder, unhealthy coping mechanisms or extreme stress, therapists will work with each patient to approach these issues in a healthy and therapeutic manner. Cognitive behavioral therapy (CBT), interpersonal therapy and dialectical behavior therapy (DBP) are three types of behavioral therapy that can be used to help treat Suboxone abuse and the associated underlying triggers.