Suboxone (Buprenorphine and Naloxone) for MAT

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By: Renaissance Recovery

Medically Reviewed by: Diana Vo, LMFT

Last Updated: 7/1/2021

suboxone | Renaissance Recovery

Authored By: Joe Gilmore

Table of Contents

Suboxone is a combination medication that contains both buprenorphine and naloxone in one tablet used in medication-assisted treatment efforts for substance use disorder. 

What is buprenorphine, then?

Buprenorphine is proven effective in treating heroin addiction. The medication works by triggering your brain’s opioid receptors, but without delivering the euphoria or the potentially dangerous side effects of opioids. In this way, buprenorphine can both reduce the severity of withdrawal symptoms and minimize the intensity of cravings for opioids.

Naloxone is considered essential to a functional health system by the World Health Organization. Combining buprenorphine with naloxone further reduces the potential for abuse. If you attempt to inject the medication to get high, you’ll experience acute withdrawal symptoms instead.

As long as you take Suboxone orally and precisely as prescribed, though, you won’t bring about any of these negative outcomes. Instead, you’ll potentially streamline the challenging early phase of opioid detox and withdrawal. It won’t be easy, but it will be easier.

Before we explore some of the possible side effects associated with Suboxone, some basics about what this medication is and how it works as part of an integrated opioid addiction treatment plan. 

What Is Suboxone?

Suboxone – a mixture of naloxone and buprenorphine – is a prescription medication used in the agonist substitution treatment of opioid use disorder. With this form of medication-assisted treatment, you’ll receive an opioid agonist in place of the opioids you have been abusing.

Suboxone is the branded version of this buprenorphine-naloxone combination. The medication comes as an oral film. You place this either between your gums and cheek or under your tongue. Either method results in the film dissolving in your mouth and the medication is then slowly metabolized.

Suboxone strips contain two different drugs, then, and they are available in four different strengths:

  • 0.5mg naloxone / 2mg buprenorphine
  • 1mg naloxone / 4mg buprenorphine
  • 2mg naloxone / 8mg buprenorphine
  • 3mg naloxone / 12 mg buprenorphine

There is some research to indicate Suboxone can be effective for minimizing opioid abuse and improving treatment retention.

Suboxone is a Schedule III prescription medication. A controlled substance, the combination medication has a recognized medical use, but could also trigger both physical and psychological abuse. The medication also has the potential for abuse.

Available in both the branded form and in generic form, this medication must be prescribed only by a doctor trained and certified by the federal government.

The generic version of this medication comes in both film and tablet form.

Is Suboxone the Same as Methadone?

Suboxone and methadone are both opioids, but they are not the same thing.

While Suboxone is only used for the treatment of opioid use disorder, methadone can be used for the treatment of chronic pain as well as for treating opioid dependence. 

MAT & Suboxone Treatment

Suboxone is typically used as a prescription medication for treating opioid dependence, but it can also be used off-label for the part of opioid withdrawal symptoms. When used in this off-label capacity, the medication is administered as part of a comprehensive detoxification program at an addiction treatment center.

The medication has FDA approval for treating opioid dependence. Suboxone is also recommended as a treatment by the American Society of Addiction Medicine.

This 2008 trial explored the effects of medication used to treat young adults diagnosed with opioid use disorder over twelve weeks. The data suggest that patients who took Suboxone in combination with counseling over the course of the trial experienced more favorable outcomes than those who followed the normal route of detoxification and counseling.

The young adults in the above study were addicted to a variety of opioids, including morphine, prescription painkillers, and heroin. Those who received the combination treatment of Suboxone and counseling were more likely to abstain from using opioids than the group who underwent short-term detox followed by counseling. They were also less likely to abuse marijuana and cocaine than the counseling-only contingent. Finally, the group administered Suboxone was also less likely to inject drugs intravenously than the control group. They were also more likely to complete the course of treatment.

Now, these findings are extremely encouraging, and they also emphasize the need for more long-term research into whether or not using Suboxone conclusively improves treatment outcomes.

A detox program typically takes place in an inpatient setting. The short-term strategy is used to wean you off either opioids or alcohol.

With treatment for opioid dependence, on the other hand, the strategy is more long-term. The bulk of treatment can be administered in an outpatient capacity.

Each of the drugs included in this combination medication performs a discrete role. Naloxone is included to minimize the chance of Suboxone being abused. As an opioid antagonist, naloxone counters the euphoric effects of opioids. Some patients attempt to inject Suboxone to get high, but the naloxone component will counter these rewarding effects, at the same time triggering instant withdrawal. If you are engaging with substitution treatment as part of MAT for opioid use disorder and you feel you may abuse the medication, speak with your treatment provider about these concerns. Using the film version of this medication releases less naloxone than injections release, so instant withdrawal would be less likely.

Buprenorphine, on the other hand, delivers some effects associated with opioid drugs, but simultaneously blocks some opioid effects. The medication is classified as a partial agonist-antagonist.

Where naloxone is included to lessen the likelihood of abuse, buprenorphine helps to minimize withdrawal symptoms and cravings.

Now you have a clear understanding of what Suboxone is and how it works, how does it go about blocking the effects of opiates and how long does it block these effects? 

How Long Does Suboxone Block Opiates?

Every situation is different, but generally speaking, Suboxone will block opiates for up to three days. That said, doctors generally ask their clients to take the medication once per day and at around the same time every day. When it comes to Suboxone, and MAT in general, the best thing you can do is follow the directions of a prescriber and addiction professional.

Treatment for opioid dependence takes place in two distinct phases and Suboxone is used in both of these:

  • Induction phase
  • Maintenance phase

In the first phase of induction, the medication can effectively mitigate the intensity of withdrawal symptoms when you reduce or discontinue the use of opioids.

Suboxone is only used during the induction phase if you are addicted to short-acting opioids. These include:

  • Codeine
  • Morphine
  • Heroin
  • Oxycodone

The medication is only used once the opioids have started to leave your system and the symptoms of withdrawal are triggered.

Once treatment is pushed into the maintenance phase, Suboxone can be used on an ongoing basis. The dosage needs to be monitored and stabilized for extended treatment to continue.

When this medication is used in the maintenance phase of treatment, the goal is to manage both withdrawal symptoms and cravings as you advance through your course of addiction treatment. This could be a few months, or treatment could last for more than a year.

You need to stop using Suboxone using a gradual dosage taper. This will ensure you don’t experience any negative side effects. More about buprenorphine side effects and Suboxone side effects next.

Suboxone Side Effects

When you use Suboxone, there is a risk of some mild and some more serious side effects.

Common Side Effects

Some of the more common Suboxone side effects include:

  • Headache
  • Redness in the mouth
  • Nausea
  • Back pain
  • Constipation
  • Depression
  • Burning tongue
  • Insomnia
  • Sweating
  • Fatigue
  • Weakness
  • Anxiety
  • Abdominal cramps
  • Rapid heart rate
  • Body aches

In the case of most of these common side effects, you’ll find they clear up in a few days, a few weeks at most. If the side effects become more severe, or if they persist for months, you should consult with your treatment provider. 

Serious Side Effects

Although uncommon, it is possible to experience some serious side effects of Suboxone.

If you notice any of the following symptoms, call your doctor. If any of these side effects appear life-threatening, call 911 immediately.

  • Chronic allergic reaction: Occasionally, Suboxone can trigger an allergic reaction like anaphylaxis. Symptoms include hives, a skin rash, swelling of the lips, tongue, and throat, along with difficulty breathing. Seek immediate medical assistance if this manifests.
  • Breathing problems: High doses of Suboxone can lead to breathing problems causing coma or death. This typically occurs when you use other drugs alongside Suboxone. It is also more likely to occur if you have COPD (chronic obstructive pulmonary disease).
  • Liver damage: Suboxone can cause liver damage, both mild and severe. 
  • Adrenal insufficiency: Using Suboxone can lead to adrenal insufficiency (reduced cortisol hormone levels).
  • Abuse and dependence: Using Suboxone long-term can lead to dependence, both physical and psychological. This risk is intensified if you use Suboxone with alcohol, other opioids, or benzodiazepines.

Severe Withdrawal Symptoms

Suboxone should only be used with short-acting opioids. If you take the medication alongside longer-acting opioids, you’re likely to experience more acute withdrawal symptoms. 

Can You Overdose on this Medication?

At this point you may be wondering, “can you overdose on subsoxone strips”? If you take Suboxone only and precisely as directed, the medication releases buprenorphine into your body slowly. This serves to lessen both withdrawal symptoms and cravings.

If you attempt to get around the time-release aspect of the medication by injecting the medication, you won’t experience a euphoric rush from the drug. Instead, the effects of the opioids are blocked from reaching your brain. This is achieved with the naloxone in Suboxone binding to your opioid receptors instead. You’ll then find yourself catapulted into withdrawal, not dangerous, but physically uncomfortable.

For those with a lower tolerance to opioids, taking Suboxone can potentially cause euphoric effects. Also, some medications can interfere with the functioning of Suboxone. Even though the medication includes naloxone, used as an opioid overdose antidote, Suboxone overdose is still possible.

Symptoms of Suboxone overdose are similar to the classic effects of opioid overdose. You can expect to experience any of the following:

  • Nausea
  • Vomiting
  • Trouble concentrating or remembering things
  • Sleepiness
  • Loss of physical coordination
  • Irritability, anxiety, and mood swings
  • Slowed heartbeat
  • Death
  • Coma
  • Depressed breathing
  • Abdominal pain
  • Seizures

One of the other known issues with this medication is the way it can sometimes lead to drug-seeking behaviors and the cravings typically associated with addiction among those taking the medication for opioid use disorder. If this leads to increasing the dose of Suboxone being ingested, it can end up in overdose.

Another danger with Suboxone is that someone taking the medication may relapse and start using the substances Suboxone is being used to treat. If this occurs and you take italong with either heroin or prescription opioids, it could lead to opioid overdose with too much of the substance in your system.

Now, perhaps you’ve accepted that you have a problem with opioid dependency and addiction, but you’ve been put off seeking treatment through fear of the withdrawal symptoms associated with opioid detox. Hopefully, today’s glimpse at medication-assisted treatment in general and this medication, in particular, has renewed your confidence in committing to recovery

How, then, can you find a Suboxone clinic without taking pot-luck on Googling “Suboxone doctors near me” and hoping for the best? 

Using Renaissance Recovery to Find Suboxone Doctors Nearby

This drug is most effective when it’s administered as part of a comprehensive addiction treatment program.

If you’re addicted to opioids, whether prescription painkillers or heroin, we have a variety of personalized inpatient and outpatient programs using a combination of medication-assisted treatment and psychotherapies like CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy). This form of integrated treatment helps streamline the discomfort of opioid withdrawal while also minimizing cravings. You’ll also equip yourself with the skills to better manage cravings as you move into sustained recovery.

Here at Renaissance Recovery’s California rehab, you’ll also have access to a range of holistic therapies and vocational development programs. If your home environment is not conducive to your recovery, we can help you access accommodation in sober living homes.

However much you feel you can’t do without opioids, we’ll help you reclaim your life and move forward opioid-free.

All you need to do is take the first vital step call our friendly team at 866.330.9449.

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