What Is Suboxone?
Suboxone is a prescription medication designed for Medication Assisted Treatment of Opioid Use Disorder. It effectively decreases withdrawal symptoms, along with cravings.
Suboxone can be prescribed by health professionals to people dependent on opioids such as heroine, fentanyl, and methadone.
What Is Suboxone?
Suboxone is a medication used to treat Opioid Use Disorder.
It is used in conjunction with psychotherapy and other interventions to help treat opioid addictions. These addictions may include heroine, oxycodone, and codeine dependencies.
Suboxone is taken once daily in a tablet or film form to help manage withdrawals associated with Opioid Use Disorder. It is made with two active ingredients: buprenorphine and naloxone.
The History of Suboxone
Opioid addictions are sadly rampant in the US. Currently, 3 million Americans are suffering from opioid addictions. This is thought to be influenced by over-prescribing of opioids in the 1990s.
This has resulted in a push to find effective treatments for opioid dependencies.
Suboxone’s forefather was originally developed in 1966 under the name Subutex. The aim was to create a medication to relieve pain that was not addictive.
Although Subutex was still useful for treatment of addictions, it remained addictive itself. This posed a risk of potential abuse of the medication that was actually used to treat other, stronger addictions.
In 1995, the National Institute on Drug Abuse combined the active ingredient of Subutex buprenorphine with Naloxone. This significantly decreased the addictive properties of buprenorphine alone and marked the creation of Suboxone.
Suboxone is currently used to treat opioid addictions, and effectively helps people to reduce their opioid dependence and decrease the likelihood of opioid overdoses.
The Composition of Suboxone
Suboxone is composed of two main ingredients: buprenorphine and naloxone. These two ingredients work together to effectively treat opioid addictions.
Buprenorphine is a partial opioid agonist. This means that it binds to the same receptors that other opioids do to help decrease pain.
It is FDA-approved for the management of acute pain, chronic pain, and opioid dependence. Since it weakly binds to the same place that other stronger opioids bind to, it helps to decrease cravings and withdrawal symptoms.
However, due to the fact that it binds to the same places that other opioid agonists such as heroin does, it has potential to create dependency when used alone.
Naloxone works in the opposite way that buprenorphine does as an opioid antagonist. Naloxone blocks the receptors that opioids work on, stopping their effects. It can therefore be used to treat opioid overdoses.
It also discourages people from injecting or otherwise abusing high levels of buprenorphine because it blocks its effects at high doses.
How Suboxone Works
Suboxone helps to treat opioid addictions by mimicking the effects of opioids such as heroin and oxycodone. As discussed above, it contains two ingredients: buprenorphine and naloxone.
Reduces withdrawal and cravings
Buprenorphine weakly binds to the same place that other opioids do. This decreases the effects of opioid drug withdrawal and cravings. It also helps to treat acute and chronic pain, which may be driving someone’s opioid addiction.
This allows people to decrease their opioid use and helps them during their recovery phase.
Minimizes risk
Because buprenorphine binds to the same receptors that stronger opioids do, there is potential that people will start abusing the medication by taking high doses. To combat this, naloxone blocks some of those opioid receptors.
This means that only enough buprenorphine can be taken to mitigate the symptoms of withdrawal. Taking any higher dose than this will not have any effect — thereby reducing the risk of dependency.
It also means that taking other stronger opioids such as heroin will not have as much of an effect on the body.
Improves outcomes
Taking Suboxone helps people who are dependent on opioids to decrease their drug use.
It also allows for psychotherapy and social interventions to be more effective as it decreases withdrawal symptoms — allowing people to focus on recovery.
The Uses of Suboxone
Treating opioid addiction
Suboxone is FDA-approved for treatment of opioid addictions.
Health care providers can prescribe Suboxone to manage dependencies on heroin, oxycodone, fentanyl and hydrocodone.
It is often used in subjection with other psychological and social interventions to help treat addiction.
Managing opioid withdrawal
Since buprenorphine — one of the active ingredients in Suboxone — mimics the effects of other stronger opioids, it helps to reduce opioid withdrawal symptoms.
This supports people to decrease their opioid use in the recovery phase.
Reducing harm in opioid dependence
The second ingredient in Suboxone — naloxone — blocks opioid receptors. This means that when someone takes higher doses of opioids, it stops them from having an effect.
This not only reduces the addictive nature of the opioid but can also be used to treat overdoses.
Sustaining therapy for opioid use disorder
Studies show that using opioid mimics such as Suboxone can help people stay in therapy for longer.
This allows people to manage underlying issues that may be driving their addiction. It also helps people to refrain from opioid use.
The Administration and Dosage of Suboxone
Common forms
Suboxone can be taken in two ways: as a sublingual tablet or sublingual films.
It is usually taken once daily under the guidance of a doctor. A doctor will prescribe the correct dose necessary to minimize opioid withdrawal symptoms.
General guidelines for administration
A doctor may prescribe Suboxone to people who are suffering from Opioid Use Disorder and who are experiencing withdrawal symptoms.
They will often prescribe sublingual tablets or films that are taken once a day to manage these symptoms.
Health care providers will follow up to make sure the medication is working, and to check for potential side effects.
Importance of a doctor’s supervision
Suboxone must be prescribed by a doctor. During this time, the doctor will monitor closely to check that the medication is safe and effective.
The doctor will make sure the dose is right for you and that your symptoms are being managed properly. If withdrawal symptoms are still present, the doctor may increase the dose.
Importantly, no medication comes without risk. Doctors play an important role to ensure that Suboxone is used safely, and look out for potential side effects such as hepatitis. They will also take blood tests and look at their function to help minimize the risks.
The Potential Side Effects and Risks of Suboxone
Like all medications, there are some potential side effects to be aware of. These include:
- Drug abuse
- Respiratory depression (slow breathing)
- Hepatitis
- Overdose risk in people who have not used opioids before
- Headache
- Nausea
- Vomiting
- Blurred vision
- Allergic reactions.
Where Is Suboxone Available?
Suboxone is able to be prescribed by certain doctors. The doctors must have a current DEA registration that includes schedule III Authority. A list of these doctors can be found on various websites.
When prescribed, the medication can be picked up from pharmacies in your local area.
The Legal Status and Regulations of Suboxone
Suboxone is a Schedule III controlled substance in the United States
Suboxone is a Schedule III controlled substance.
This means that it is deemed to have a moderate to low potential for abuse compared to drugs in higher schedules. However, they still have a potential for psychological or physical dependence.
Drugs in this schedule have acceptable medical uses but must be prescribed by a doctor.
Suboxone can only be prescribed by healthcare providers with a Drug Enforcement Administration (DEA) registration
Doctors that prescribe Suboxone must have a DEA registration. This means that they are legally authorized to handle controlled substances in the US, including Suboxone.
Dispensing and distribution of Suboxone are subject to strict regulations to prevent misuse
Suboxone distribution is under strict guidelines and is frequently monitored to prevent its abuse.
All pharmacies and pharmacists have a legal duty to check the validity of Suboxone prescriptions. They are also able to be prosecuted for inappropriate distribution and are frequently monitored by the DEA.
The DEA also frequently monitors pharmacies’ Suboxone ordering for suspicious activity.
The Common Myths About Suboxone Treatment
Suboxone substitutes one addiction for another
One of the ingredients used in Suboxone (naloxone) blocks the opioid receptor, preventing addiction. When used alone, it does not result in a high.
As such, Suboxone is much less addictive than opioids such as heroin and oxycodone.
Suboxone is only for detox, not long-term treatment
Suboxone can be prescribed for long periods of time, depending on someone’s needs and risks.
In fact, studies show that long term Suboxone use can decrease opioid use, opioid related hospitalizations, and overdoses related to opioid use disorder.
Suboxone is always misused by patients
Suboxone is rarely misused by patients, as people do not experience the high associated with other opioids.
If it is misused, it is often by patients who are managing withdrawal symptoms from opioid use without a valid prescription.
Suboxone cures opioid addiction and withdrawal completely
Suboxone treats withdrawal symptoms and cravings associated with opioid drug use.
However, it is not a cure for addiction. It can help to treat addiction together with treatment plans involving other social and psychological interventions that treat the underlying drivers of addiction.
Like any addiction, it takes patience and work to tackle.
Suboxone is as addictive and impairing as other opioids
Suboxone is much less addictive and impairing than other opioids.
It only partially activates the opioid centers, and the use of an antagonist blocks the effects of high doses. Therefore, it does not produce a high when used alone and the risk for addiction and impairment is low.
Suboxone is only for severe addiction
Suboxone can be prescribed for mild to moderate Opioid Use Disorder by health professionals.
If the doctor suspects withdrawal from opioids, then they are able to prescribe Suboxone.
Suboxone treatment doesn’t need counseling
Some states (such as Ohio) require people who have been prescribed Suboxone to receive counseling.
Other states do not require this. However, counseling is useful for many people — in particular for those who struggle with opioid dependency. Whilst Suboxone is great for treating physical dependence, counseling is great for treating emotional triggers.
Suboxone is a quick fix without lifestyle changes
Opioid addiction is complicated and influenced by many social, psychological, and environmental factors. Unfortunately, there is no quick fix. Whilst Suboxone is great for treating withdrawal symptoms, lifestyle changes will help to sustain sobriety.
Building strong relationships and focusing on health are some great strategies for managing opioid use disorder in the long term.
Conclusion
Suboxone can be used to treat withdrawal and cravings associated with Opioid Use Disorder.
It can also be used to treat acute and chronic pain, without the addiction risk of other drugs such morphine and fentanyl.
Suboxone is available as a sublingual tablet, or film and can be prescribed by certain doctors as part of a treatment plan.
FAQs about Suboxone
What is Suboxone used for?
Suboxone is used for treatment of acute and chronic pain.
It is also used to treat opioid withdrawal symptoms and cravings in people addicted to heroin, oxycodone, fentanyl, and other opioids.
What class of drug is Suboxone?
Suboxone works on opioid receptors and is therefore part of the opioid drug class.
It is a Schedule III drug, meaning it must be prescribed by a doctor and obtained from a licensed pharmacy.
Is Suboxone considered a narcotic?
Because Suboxone contains an opioid, it could technically be considered a narcotic.
However, ingredients such as naloxone ensure that it does not create addictions.
Is Suboxone used as a painkiller?
Yes, Suboxone is FDA-approved for treatment of acute and chronic pain.
It effectively manages pain while reducing the risk of opioid addiction associated with morphine, fentanyl, and other drugs.
What are side effects of Suboxone?
Like any drug, Suboxone can have side effects.
Common side effects include nausea, vomiting and headaches. Less common, more severe side effects include respiratory depression and hepatitis.
Doctors will ensure the risks of these serious side effects are minimized (by running blood tests, for example) to assess whether you are at risk.
How safe is Suboxone?
Suboxone is considered safe when used properly.
It is important to note that Suboxone can interact with some other medications, such as antidepressants.
Although risks are present, doctors will try to minimize the risks with regular monitoring. It is important to regularly visit your doctor when taking Suboxone and tell them about any medications you are taking, or side effects such as allergic reactions you may be experiencing.
References
https://nida.nih.gov/sites/default/files/policybrief-effectivetreatments.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7097731/
https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020733s024lbl.pdf
https://www.samhsa.gov/medication-assisted-treatment/find-treatment/treatment-practitioner-locator
https://jamanetwork.com/journals/jama-health-forum/fullarticle/2795746
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
https://pubmed.ncbi.nlm.nih.gov/32364847/
https://www.caron.org/blog/how-does-suboxone-work-5-common-myths-debunked
https://www.palmpartners.com/therapy-requirement-suboxone-treatment/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
