Suboxone Use Disorder Treatment
Medically Reviewed by
Dr. David Hu, MD on 11/03/2022
Dr. Hu is a nationally licensed psychiatrist with 21 years of experience treating mental and behavioral health.
By: Zinnia Healing Editorial Staff | Edited By: Rebecca Hill
Suboxone Use: Helping People Get on the Road to Recovery
Opioid addiction is a deadly problem, to the point where opioid overdoses take more than 100 lives every day in the United States alone. Common forms of opioids include OxyContin, codeine, Vicodin, and heroin. Given how addictive opioids are, recovery is extremely difficult. Fortunately, certain medications have shown great promise in helping people overcome an opioid addiction.
Medications like Suboxone have been successfully used to help treat opioid addiction. This particular medication has been approved for this use since 2002. In the decades since its approval, Suboxone has continued to show how a combination of drugs administered in small amounts can help individuals recover from addiction with fewer side effects and a greater chance of success.
Unfortunately, Suboxone can be misused, which is why administration and support from a professional recovery team is so important in overcoming addictions. In this article, we’ll explore the history of Suboxone, how it works and how it is purposefully misused. We’ll also discuss treatment options and how a person can achieve recovery from a drug addiction.
What Is Suboxone?
Suboxone is not the only medication used to treat opioid addiction, but it is among the most common. Suboxone has been used in drug recovery since 2002. The medication contains a mix of two drugs: buprenorphine and naloxone. Buprenorphine is a semisynthetic opioid, while naloxone is an opioid antagonist. Here’s what that means.
Buprenorphine, the semisynthetic opioid in Suboxone, is the active drug in the medication. Buprenorphine falls into a class of partial opioid agonists, which means buprenorphine is not as strong as other opioids, like heroin. Buprenorphine also has a ceiling, which means the effects stop increasing, even as someone increases their dosage. The ceiling helps reduce the risk of dependency and overdose, while also minimizing side effects.
Naloxone is the other ingredient in Suboxone, and it’s a type of opioid antagonist or opioid blocker. Naloxone binds to the same receptors that opioids would bind to, but naloxone blocks the opioids, preventing them from triggering the release of dopamine. In other words, taking naloxone prevents opioids from being processed by the brain. Naloxone is sold as Narcan, which is used to prevent the absorption of opioids during an overdose.
If taken as prescribed, the naloxone in Suboxone will not affect the body at all, meaning it will not block the opioid receptors in the brain. However, if a person injects Suboxone, which they are likely to do with Suboxone abuse, the naloxone will take effect. If a person injects Suboxone, the naloxone activates, blocking the opioid receptors in the brain, causing uncomfortable withdrawal symptoms. So, the purpose of including naloxone in Suboxone is to discourage injection and misuse of the drug.
The History of Suboxone
Addiction recovery specialists have tried many methods for reducing a person’s dependency on a drug while minimizing side effects and discomfort. One of the most common methods of treating opioid addiction is to switch a person from the opioid they’re using to a less potent, less dangerous opioid. From there, the specialists work to decrease the person’s dose gradually until they’re free from opioid use altogether.
Using this method of switching opioids and gradually lowering the dose, specialists are able to avoid the intense withdrawal symptoms and drug cravings that often plague individuals who are trying to recover from addiction. Not only are those symptoms and cravings difficult to deal with, but they can be so intense that they cause a person to revert to drug use.
1. Why Was Suboxone Developed?
The method of switching a person to a different, weaker opioid is well-proven, but the exact drug used in the process varies. Methadone was one of the first drugs used in this process, and it was used for a long period to where it became the standard medication for heroin addiction recovery.
Methadone was quite potent in itself, which put people at a higher risk of overdose. Due to methadone’s strength, it had to be kept under tight control and could only be administered by a trained medical professional within a dedicated, licensed methadone clinic.
Individuals seeking treatment for their addiction had to travel to a special clinic every day to receive their dose, and that inconvenience contributed to many people dropping out of the program before they completed their recovery. Medical scientists sought to combat the challenges that methadone presented, namely its high potency and risk of overdose. In doing so, they developed buprenorphine.
Compared to methadone, buprenorphine has a much lower potential for overdose and that allowed it to be dispensed by pharmacies as a take-home prescription. This meant those in recovery could now self-administer their medication, increasing the likelihood that a person would complete their recovery program.
However, because buprenorphine could be prescribed and taken home, with multiple doses being packaged and handed to the individual at a time, this led to the potential for misuse of the drug. To reduce the potential for misuse, scientists began combining naloxone with buprenorphine, creating the drug known as Suboxone.
2. How Does Suboxone Work?
Buprenorphine is far less risky and addictive than methadone. Even when taken in large doses, buprenorphine will at most create a low-level high for a recovering opioid user.
The only way to induce a real opioid-like effect for a user is to dissolve the buprenorphine and inject it, but the combination of buprenorphine and naloxone in Suboxone makes that ineffective, too. If a person dissolves the Suboxone and tries to inject it, the naloxone then activates and blocks the brain’s opioid receptors, which prevents any feelings of “high” at all. Instead, the individual is often met with withdrawal symptoms.
This concept was not only innovative, but game-changing, and it rapidly led to Suboxone becoming a widely used medication. In 2013 alone, Suboxone sales added up to over $1.5 billion.
3. Is Suboxone Addictive?
The astounding combination of buprenorphine and naloxone means recovering opioid users will experience little, if any, “high” effects from using Suboxone, even if they inject it. For those without experience taking opioids who have not built up the dependence and tolerance, Suboxone can still create a feeling of high.
For a person who does not have an opioid tolerance, Suboxone has high addiction potential. This addictive quality means that Suboxone and similar medications have found their way onto the illicit drug market, which has led to some people lying to their doctors about their lifestyle to get a Suboxone prescription.
Ultimately, Suboxone is still a type of opioid, and while it helps many on the path to treatment, it hurts many others who misuse it. For that reason, it’s important to understand the signs of Suboxone abuse in the next steps in treating it.
Who Misuses Suboxone?
While illicit opioids exist on the market, like heroin, prescription opioids like Suboxone are also commonly abused. Many people obtain prescription opioids either by lying to their doctor so they can get a prescription or through the black market of Suboxone resale.
For those without an opioid tolerance, Suboxone produces an addictive high. In order to achieve that high, a person would need to take Suboxone in a higher-than-normal dose or mix it with another intoxicant, which greatly increases a person’s risk of overdose. The wide availability of Suboxone has also contributed to alarming numbers when it comes to recreational misuse of the drug and overdose-related emergencies and deaths.
As with any opioid, there are no bounds of place, age, or race that protect someone from being a victim of Suboxone abuse. Those most vulnerable to misuse include high school students and college-aged young adults. These populations are most at risk because of peer pressure, routine experimentation, and lifestyle stressors.
When looking at usage divided amongst genders, men are considered more susceptible to prescription drug misuse than women. However, when looking specifically at people between the ages of 12 and 17, girls are more likely to use a prescription drug for non-medical reasons than boys of the same age. Misuse can also happen in cases where an individual needs opioids for pain relief and receives a prescription.
When looking at those scenarios where an individual has a painful chronic condition, women are more likely to be prescribed opioids than men, but men are at a higher risk of misusing them when prescribed.
Lastly, there are noted racial differences when studying the misuse of prescription opioids. It is well-known that minority communities have been devastated by the heroin epidemic, but heroin use has risen substantially amongst white people while use amongst other races has remained steady. Researchers also believe that under-treatment for people of color contributes to this phenomenon, because people of color are less likely to be prescribed opioids at all.
Common Misconceptions About Suboxone
Suboxone is far from the only prescription drug that is being abused, but it is among the most common. Researchers have spent a great deal of time learning what causes prescription drug abuse, so that they can help inform organizations who are investing in outreach programs to help stop it. They have found several misconceptions about Suboxone and other prescription drugs that contribute to its misuse.
One of the biggest misconceptions about Suboxone is that it’s safe, or safer, just because a doctor can prescribe it to you. Suboxone is considered safe for its intended purpose—that is, administration in small doses to treat severe opioid addictions. When used improperly, Suboxone is just as dangerous as any other drug. However, this misconception that Suboxone is somehow safer has contributed to accidental overdoses and deaths.
Prescription drug abuse has led to more overdose deaths than cocaine and heroin combined. That’s why public education efforts are so worthwhile. By teaching children and young adults, especially those in the highest risk categories, about what makes prescription drugs so dangerous, communities will begin to see a decline in the misuse of these drugs, but it begins with outreach.
Suboxone Withdrawal Symptoms
When a person has become dependent on a drug and then stops taking it, they go through a period known as withdrawal. The withdrawal symptoms can be severe, and for Suboxone users, they may include nausea, vomiting, stomach upset, muscle aches, body aches, trouble sleeping, fatigue, irritability, anxiety, depression, difficulty concentrating, headache, sweating and chills. Fortunately, when Suboxone is used properly to treat opioid addiction, withdrawal symptoms are minimal.
When supervised by a medical professional, Suboxone can help an individual avoid withdrawal symptoms from the opioid they were using. Since the person will gradually take a smaller and smaller dose of Suboxone, they can often avoid any severe withdrawal symptoms at all. However, when someone uses Suboxone, withdrawal symptoms are likely. When they stop taking the drug, or between taking the drug, they’re likely to experience side effects.
Opioid addictions are powerful and, while those recovering are strong, no one is strong enough to overcome the addictive qualities of opioids on their own.
Addictions have two components to tackle: The physical and the psychological. The physical symptoms are uncomfortable, but the psychological symptoms can be the hardest to overcome. For many recovering users, it’s the emotional and mental side effects of stopping use that pose the biggest challenge.
Rather than trying to face withdrawal on their own, it is highly recommended that an individual seeks out a treatment center that can walk them through a medical detox process to minimize discomfort, keep them safe, and maximize the chance of long-term addiction recovery.
Seeking Treatment for Suboxone Abuse
Suboxone is a life-saving drug that has helped many recover from opioid addictions that could have otherwise taken their lives. While Suboxone features an innovative combination of naloxone to help prevent misuse, it can still be abused. Taking too much Suboxone or combining it with other substances are two common ways that users become dependent on this drug.
While Suboxone is safer than methadone, don’t be fooled. Suboxone is still an opiate, and it can lead to a life-altering addiction, especially for someone who does not already have an opioid tolerance built up from prior use. The “ceiling” effect of Suboxone, which limits the high a person can feel, also contributes to the high risk of overdose because it can lead an individual to taking more and more to get a stronger result.
Ultimately, Suboxone should never be thought of as safe or “safer,” even though it is a prescription drug. When misused, it poses a threat to life like any other opioid, and treatment requires the help of addiction specialists. Zinnia Healing can be the bridge that helps you see the light at the end of the tunnel and get past your opioid addiction once and for all.
The caring professionals at Zinnia Healing use a combination of therapy, wellness, fitness, nutrition, and goal-setting techniques to help you get on the path to living a full and fulfilling life. Regardless of what your circumstances are today, Zinnia Healing can set you up for a brighter tomorrow. Are you interested in learning more about recovery and how it works? Reach out to us today.