Suboxone is a prescription medication used to help people quit their dependence on opioids. This includes all legal prescription opioid drugs and the illegal narcotic heroin. Recovering opioid users take the medication during the withdrawal process under the supervision of a medical professional. Suboxone has gained acceptance as a safe and effective way to treat opioid addiction. However, it is not without its risks, and users can develop an addiction to it as well if it is abused or not used as directed.
Suboxone is the brand name for the opioid agonist drug made up of two drugs, which are buprenorphine and naloxone. It comes in the form of a sublingual strip or tablet that is inserted under the tongue when taken. An “opioid agonist drug” means that while buprenorphine acts on the same opioid receptors in the brain as more potent opioid drugs, they are weaker when compared to the effects of other opioids, such as heroin and methadone.
Suboxone also contains naloxone (brand name Narcan), which blocks the effects of full agonist opioids from attaching to the opioid receptors. SAMHSA explains that the medication was added to buprenorphine “to decrease the likelihood of diversion and misuse of the combination drug product.”
The medication’s effects will increase with every dose taken until the doses become moderate. Once moderate doses are reached, the drug’s effects level off, SAMHSA explains, even if the doses increase. This is called a “ceiling effect,” and it is designed to lower the risks of people misusing it or becoming dependent on it. This feature is also supposed to minimize its side effects, which are similar to those of other drugs in this class. Common ones include nausea, vomiting, and constipation, muscle aches and cramps, cravings, irritability, and sleep disturbances.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), buprenorphine can:
Buprenorphine is used in medication-assisted treatment (MAT), which uses Suboxone along with counseling and behavioral therapies to help people end opioid dependency.
While Suboxone helps opioid-dependent people recover, it is habit-forming if users are not careful. According to SAMHSA, there is potential for the medication to be misused, particularly by people who do not have opioid use disorder. People who misuse and/or abuse the drug do so because they want to feel euphoria, reduced pain, or calm and relaxed. Some people may also use the drugs to help them manage cravings for other opioids and drugs.
When buprenorphine is injected, the effects of naloxone can bring on opioid withdrawal symptoms in users, SAMHSA says. Abusing the drug includes but is not limited to taking the medication outside of a prescription; taking the medication longer than prescribed; buying, selling, or trading Suboxone, which is illegal, or using it with other drugs, such as alcohol and other opioids.
Signs of abuse include insomnia, watery eyes, diarrhea, fever, sweating, slurred speech, memory impairment issues. Abuse can become an addiction.
A clear sign of Suboxone addiction is when users go into withdrawal when they stop using the drug or reduce their use. These withdrawals signal changes in the body and brain as both adjust to not having the drug in the amounts they have become accustomed to. It is recommended that Suboxone users avoid quitting the drug abruptly after long-term use. Doing so can lead to a relapse, which can bring on other problems. Instead of going cold turkey to end Suboxone dependence, users are advised to seek treatment at a reputable drug rehabilitation facility.
People who can’t seem to stop using Suboxone likely have developed a dependence. Addiction treatment should be customized to suit what’s in the best interests of the individual’s needs and situation. Upon entering treatment, one will find a medical detox is the first step to recovery. During this three- to seven-day period, a person will be gradually tapered off Suboxone use to ensure the weaning process is done correctly. Doctors and nurses remain on hand 24/7 to monitor the recovering individual. They may administer medications that address withdrawal symptoms so medical stability can be attained.
After the detox stage is complete, clients will be presented with treatment options based on their personal evaluation. All options promote a focus on addiction recovery. Depending on the severity and seriousness of one’s Suboxone use, a long-term residential or inpatient treatment program may be recommended. If the person is in the early stages of Suboxone addiction or has a mild case of it, then the person may benefit more from a shorter-term outpatient treatment program that allows treatment with more flexibility.
Both options allow recovering substance users to receive therapy and counseling they need to address their addictions and learn about the reasons for their substance use and what they can do to remain sober in the future.
Cognitive-behavioral therapy (CBT) is a commonly used psychotherapy that teaches recovering users how to change self-defeating thoughts and beliefs that are aligned with dysfunctional behaviors that encourage drug abuse. People in addiction treatment also gain a supportive community of addiction specialists and like-minded peers who also are committed to a new life in sobriety. Having such a network keeps many people focused on their goals and make them more attainable.
After treatment at a facility ends, clients are encouraged to continue aftercare treatment, which can be effective in staying away from drugs and alcohol, and triggers that have led to past use. This treatment includes outpatient treatment programs, alumni programs, support groups, and fellowships such as 12 steps.
Overdosing on Suboxone is hard to do, but it’s not impossible. It is more likely to happen when users abuse it along with other substances, such as alcohol and benzodiazepines. Combining lethal substances can gradually slow breathing and heart rate, induce coma, and even cause death.