Call us today
Suboxone was initially marketed by the British company Reckitt Benckiser as a pain reliever for chronic pain.
It proved to be very effective in small doses; however, because of its chemical composition, it did not produce the same euphoria that other opioid medications (narcotic medications) did and was believed to be at less risk for abuse.
The drug of choice at that time to assist with recovery from heroin addiction was methadone, but methadone also carried a risk of addiction. Researchers found Suboxone was also an excellent candidate for opioid replacement therapy (a drug that can be used to decrease the physical withdrawal from opioid drugs as people attempt to recover from opioid addiction). Suboxone became legal in the United States in 2000 and was approved for treatment for opioid addiction in 2002. It still may be used for pain management, especially for people with opioid addictions.
The United States Drug Enforcement Agency rates Suboxone as a Schedule III drug, meaning that it is believed to have a moderate to low potential for addiction and can only be purchased legally with a prescription from a physician.
Suboxone is a medication designed to treat addiction to opioid drugs (narcotic drugs), such as morphine, heroin, oxycodone, and other narcotic drugs. Two other medications, methadone and naltrexone, were also developed to treat addiction to narcotic drugs; however, Suboxone is quite different than these drugs.
Suboxone is a drug that contains a combination of two drugs:
According to Steven Stahl, MD, the author of Stahl’s Essential Psychopharmacology , a partial opioid blocker, like buprenorphine, is an opioid drug that creates less of an effect than would be experienced with full narcotic drugs, such as oxycodone, morphine, or heroin. Thus:
Naloxone, an opioid antagonist, is also a medication used to treat addiction to narcotics that fit perfectly onto the opioid receptor cells in the brain. When Suboxone is taken as directed, in tablet form and dissolved under the tongue:
Suboxone is relatively long-acting. Based on the current available research performed:
Based on available double-blind, placebo-controlled clinical research findings, it appears that Suboxone has relatively fewer side effects than other medications used for opioid addiction. The following side effects appear to be most common:
Some behavioral side effects may also occur:
Some of the symptoms of overdose are:
Extreme overdose may produce:
Despite claims made by the manufacturer that Suboxone has built-in safeguards towards reducing or eliminating the potential for abuse and addiction, there are reports of illegal sales of Suboxone on the street as well as a rise in the number of cases admitted to emergency rooms with signs of Suboxone overdose. These are both indications that there is a trend, even if it is a minor trend, for Suboxone abuse. Even though Suboxone is a difficult drug to abuse, the evidence suggests that Suboxone abuse does occur.
Based on available research, the ceiling effects of Suboxone appeared to top out at around a dose of 32 mg, which indicates that higher doses than that will not produce any measurable effects, such as mild euphoria. The naloxone component to Suboxone indicates that it is pointless to inject the drug in most cases; however, there are reports of Suboxone being ground up and snorted. Moreover, street sales of Suboxone indicate that it is being sold without a prescription, making it illegal. This is a form of abuse and also opens the door for it to be mixed with other drugs, such as alcohol or benzodiazepines. It appears that benzodiazepines may be often used in conjunction with Suboxone, indicating serious cases of abuse.
Mixing Suboxone will alcohol or benzodiazepines enhances the effects of both the drugs and increases the probability for adverse consequences. These consequences are typically potential serious respiratory problems and even respiratory failure. Mixing these drugs together increases the potential of an overdose.
Of the side effects of abuse that may occur, the following are potential side effects that one should look for if one suspects a person is abusing Suboxone and/or alcohol or benzodiazepines:
While it is most likely difficult to develop an addiction to Suboxone alone, people taking it for any reason may develop a mild physical dependence on the drug, due to the nature of main ingredient in the drug, buprenorphine.
The terms addiction and dependence are often used interchangeably; however, there is a real distinction between having a physical dependence on a specific drug and being addicted to the drug. Moreover, a great number of individuals develop a physical dependence to drugs they are taking for legitimate therapeutic reasons as in the case of an individual with severe rheumatoid arthritis who takes narcotic painkillers in order to function daily. A person can develop a physical dependence on a particular medication and not be addicted to it.
Physical dependence consists of physical qualities of tolerance and withdrawal:
Addiction refers to a chronic condition that can be physical, psychological, or both, and that is characterized by nonmedical use of the drug that results in impaired control over drug use, or compulsive use of the drug despite suffering negative consequences for using it. Addiction may or may not include the symptoms of tolerance and withdrawal.
Thus, it is important to remember that everyone who uses Suboxone will most likely develop at least a low-level physical dependence on the drug, depending on the amount taken and length of use; however, due to the chemical makeup of Suboxone, becoming seriously addicted to it is rare.
If a person demonstrates symptoms of withdrawal, these may often suggest that the person is suffering from substance abuse, as even individuals with prescriptions who are physically dependent on the drug should not, under normal treatment conditions, experience significant withdrawal symptoms.
Buprenorphine, the main active ingredient in Suboxone, is an opioid drug and discontinuing it abruptly will result in physical withdrawal, although the withdrawal effects may be significantly less intense than withdrawal from other opioid drugs such as morphine, heroin, or even methadone. Nonetheless, according to research, the following physical effects can occur from withdrawal from Suboxone:
Typically, just one of these symptoms will not indicate withdrawal syndrome; however, three or more symptoms occurring in an individual who has stopped using Suboxone could be a sign of physical withdrawal. Of course, several symptoms relate to other physical issues, such as an infection or illness, and it is important to rule those potential conditions out.
An intervention is a more formal approach to confront someone whose behavior is affecting others or may be self-damaging. Typically, the people involved in interventions consist of relatives and close friends as well as a professional, such as an interventionist or family mediator.
Discontinuing Suboxone is not much different than discontinuing any other opioid drug. There are specific concerns and issues regarding stopping the drug, and anyone who is going to attempt to discontinue Suboxone use should do so under the supervision of a physician. A person should not try to discontinue the drug alone due to the potential withdrawal effects and other unforeseen medical issues that may arise, such as increased physical pain that was controlled by using the drug. Physicians are best equipped to handle these issues.
In cases where Suboxone abuse is performed in conjunction with use of other drugs, such as alcohol, procedures to initiate the discontinuation of those drugs will also need to be implemented. Medical detox ensures that the individual can safely withdraw from all substances of abuse.
Discontinuing Suboxone is similar to discontinuing other opioid drugs; however, there are some specific issues with Suboxone abuse that can complicate the situation. Individuals who receive support and understanding can be successful in their efforts to discontinue using Suboxone, whether their use of the drug stems from attempts to discontinue other opiate drugs or whether their use of Suboxone itself represents a substance use disorder.
You Can Start a New Life
Contact us today to talk with a Admission Navigator who will give you the information you need to make the right decision for you and your loved ones.