Suboxone, which is a sublingual combination tablet containing buprenorphine and naloxone, is a treatment option available to you at Colonial Management Group clinics. Our addiction professionals can assist you in determining if Suboxone is an appropriate choice that meets your needs. Some of the frequently asked questions about this treatment are:
What is Buprenorphine?
Buprenorphine is a partial opioid agonist which means that its opioid effects are limited when compared to substances like Oxycontin or heroin, which are full opioid agonists. At low doses buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The safety profile of buprenorphine, pharmacologically, makes it an attractive treatment option for patients addicted to opioids as well as for the addiction professionals treating them.
What is Naloxone?
Naloxone is an opioid antagonist. Naloxone is added to prevent people from diverting the medication and using it inappropriately. Antagonists also bind to brain receptors, but instead of activating receptors, they block receptors by preventing receptors from being activated. Suboxone is a very safe medication when used as directed. If not used correctly, the naloxone in Suboxone can cause opiate dependent patients to go into full withdrawal.
How long has Suboxone been available for use in treating opioid dependency issues?
To date, a conservative estimate is that over 400,000 opioid dependent patients, worldwide, have been treated with buprenorphine. In October 2002, the Food and Drug Administration (FDA) approved the buprenorphine product Subutex, and the buprenorphine/naloxone combination product, Suboxone, for use in opioid addiction treatment in the United States. Subutex and Suboxone are currently the only Schedule III, IV, or V medications to have received FDA approval for this indication. This approval of these buprenorphine formulations did not affect the status of other medication-assisted opioid addiction treatments, such as methadone, a Schedule II formulation. In Europe, where some of the original clinical trials first took place, buprenorphine was introduced in the mid 1990s.
Isn’t the use of Suboxone just switching one addiction for another one?
As is the case with most patients who are taking medication for a persistent condition, patients who use buprenorphine product do become physically dependent on it. Due to the fact that it is a partial opioid agonist, there are no strong side effects. It seems to manifest less physical dependence, a limited feeling of euphoria, and less chance for abuse than there might be with a full agonist such as hydrocodone or heroin; as well as milder withdrawal symptoms than with full agonists. When a patient is ready to stop taking Suboxone, the dose is slowly tapered and managed by the addiction professionals treating the patient.
Is there an average length of time that a patient would be on Suboxone?
The length of treatment varies with each individual patient and is affected by many factors such as abused drug of choice, length of addiction and level of dependency, and previous treatment and relapse history. A short term detoxification may be available for some patients; however, some cases may need to be treated as a chronic condition. This affords the opportunity to address not only the physical dependence, but the psychosocial needs of the patient, as well. Relapse occurrence has a higher chance of happening if patients are not given enough time to learn the life-skills that will help them maintain an addiction free life.
Is it possible to change from methadone maintenance to Suboxone?
Because it’s quite important to be well into the first stages of withdrawal (mild to moderate) when you take an initial dose of Suboxone, and because each patient’s needs are very individualized, it is possible, but should be thoroughly discussed with the addiction professionals who are treating you. If there are other opiates present in your system, taking the initial dose of Suboxone would cause it to compete with those other opiates, which could cause a precipitated instance of withdrawal and could make the patient feel sick.
Are there any safety concerns that I should have with using Suboxone?
With any medication in general, and particularly with opiates, it is critically important to follow the addiction professionals’ instructions when taking Suboxone. Injected abuse of buprenorphine, especially when used in combination with benzodiazepines or other depressants (including alcohol), has been linked to respiratory failure and death. Any mixing of your regular dose, particularly with depressants of any kind, sleeping pills, antidepressants, or any other opioid medications, can lead to over-sedation, unconsciousness, and death. It is important to make the addictions professionals’ team fully aware of any medications that are currently prescribed, or being taken. Additionally, there are no conclusive or controlled studies of Suboxone use in pregnancy.
Please contact the Colonial Management Group clinic nearest you for any further information regarding Suboxone treatment for opiate addiction, or, for any opiate addiction treatment questions you might have.