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Most people are unfamiliar with Suboxone and how it is used in the treatment of opiate addiction. The following questions and answers are provided to educate, dispel myths and familiarize people with
Suboxone and its use in treatment. As always, if you have any additional questions or would like to share your comments you can always contact the staff of CBH via e-mail at info@centerforbehavioralhealth.com or contact any of our individual clinic locations.
What is opioid dependence? Opioids, such as some prescription pain medications or heroin, attach to the opioid receptors in the brain, which stimulate the release of dopamine and produce pleasurable feelings. When the opioid eventually detaches from the receptors, people experience withdrawal and cravings and have a strong need to repeat the experience. The need to satisfy cravings or avoid withdrawal can be so intense that people who want to stop taking opioids find this difficult to do. Or, they may find themselves doing things they wouldn’t ordinarily do in order to obtain more of the drug they crave. For this reason, even though opioid dependence is a medical condition and not a moral failing, it can drive behavior. Drug use often begins as a choice, but frequent use can cause the brain cells to change the way they work. The brain is “re-set” to think that the drug is necessary for survival. Researchers have discovered that many drugs, including opioids, cause long-term changes in the brain. These3 changes can cause people to have cravings years after they stop taking drugs.
What is Suboxone? Suboxone is the newest medication available to block painful withdrawal symptoms and cravings in order to feel normal again. Suboxone is the first opioid medication for treatment in a private office setting. Buprenorphine is the active ingredient in Suboxone, which is a partial opioid agonist, that when taken once daily, blocks other opioids from attaching to receptors in the brain. This treatment can help you stop misusing opioids. Treatment, including counseling, can help you rebuild your life.
What is a partial opioid agonist? A partial agonist is an opioid that produces less effect than a full agonist when it binds to opioid receptors in the brain. The way different opioids work can be explained using a lock and key example. Receptors are like a lock to a door. Only the right key will fit the lock, and only opioid-like drugs fit opioid receptors. With a full opioid agonist such as oxycodone, hydrocodone, morphine, methadone, or heroin, the key fits the lock, opens the door wide, and produces full opioid effects (the feeling of euphoria, or being high, as well as the side effects.) With a partial opioid agonist such as buprenorphine, the key fits the lock but doesn’t open the door all the way, so it prodices less than full opioid agonist effects and, at the appropriate dose, blocks other opioids from opening the door fully.
How effective is Suboxone treatment? It has been well documented that Suboxone helps control symptoms and cravings, so that a person can focus on resolving issues and gaining relapse prevention skills in counseling. Patients report they feel "normal" again, like they did before they ever abused opiates.
How does Suboxone work? Suboxone contains buprenorphine, which is a partial opiate agonist with a series of actions that make it possible to block painful withdrawal symptoms and cravings. A partial agonist produces limited effects and doesn’t allow other opioids to enter. Suboxone contains naloxone, which is an opioid antagonist. An opioid antagonist fits into the receptor but blocks all opioids. The naloxone in Suboxone is there to deter people from dissolving Suboxone and injecting it. When Suboxone is placed under the tongue as prescribed, very little naloxone is absorbed into the bloodstream. When Suboxone is used incorrectly, by injecting, its naloxone component can cause withdrawal symptoms to rapidly occur.
Is Suboxone addictive? Physical dependence to a drug is part of addiction, but that is not the whole story. Addiction is characterized by compulsive use of the drug, and that simply does not happen with Suboxone. The Suboxone patient is no more an addict than the diabetic who is dependent on insulin. They do not seek out the drug in the absence of withdrawal symptoms or pain; their lives do not revolve around use of the drug.
How long does treatment take? You and your treatment team decide what will be an appropriate length of treatment to ensure the best outcome for you. Although short-term treatment may be an effective option for some people, it may not allow others enough time to address the psychological and behavioral components of their disease. Since physical dependence is only part of opioid dependence, the chances of relapsing can be higher with short-term treatment because patients have less time to learn the skills necessary to maintain an opioid-free lifestyle. Suppressing cravings with Suboxone (for as long as you need) combined with counseling and or support, can often increase the level of treatment success.
What will Suboxone treatment be like? Please call our office to speak with a professional counselor that specializes in opioid addiction to book an appointment with our treatment team. At the first visit, the treatment providers, including a doctor, a nurse and a counselor will ask questions about use in order to provide the best treatment. Medication is given within a short time in order to relieve withdrawal symptoms. After an observation period, additional medication may be necessary. A prescription for one week is provided. The treatment team will reassess in one week, and at that time, can write a prescription for up to a month at a time when that is clinically indicated.
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