Suboxone is the brand name of a drug containing buprenorphine, a medication designed to help those addicted to opioid painkillers achieve recovery.
Buprenorphine was developed as a semi-synthetic alternative to methadone, which is best known as a medication that those addicted to heroin can switch onto in order to avoid the intense cravings and harsh withdrawal symptoms associated with attempting to quit.
Opioids like heroin, morphine, and OxyContin are highly addictive. According to the American Society of Addiction Medicine, 1.9 million people in the US were addicted to a prescription pain reliever and other 586,000 were addicted to heroin in 2014. They produce an intense euphoric high that creates a feeling of warm pleasure all over the body. The fast-acting nature of these narcotics means that abuse can soon lead to a physical tolerance wherein the body begins to adjust to the substance, and higher and higher doses are needed to achieve the same effect. Eventually, the changes in the body and brain will produce physical withdrawal symptoms when the individual stops taking the drug.
How Suboxone Works
Drugs like Suboxone are still opioids, but they don’t produce the same kind of high that heroin and morphine do – those who have been abusing these latter drugs will not experience a high at all if Suboxone is taken as prescribed. Suboxone also stays in the system for much longer, meaning the tolerance-building and addiction potential are significantly less than with more potent opioids. Individuals can therefore be switched onto Suboxone and have the dose of that medication gradually lowered until they’re off it completely. Though it’s not always effective, it has helped many people get on the road to recovery.
Buprenorphine is considered to be a more convenient medication than methadone due to the fact that it does not need to be so strictly controlled. With methadone, the potential for overdose is so high that those using it to treat their addictions have to travel to a hospital or addiction treatment center every day in order to be administered each dose by a doctor. Buprenorphine is much harder to overdose on, allowing clients to take multiple doses home to self-administer. This is a great option for those who do not have the time or money to travel to a medical facility on a daily basis for a dose of a medication they may be on for a long time.
However, the fact remains that buprenorphine is an opioid and has the potential for abuse, addiction, and even overdose. How safe it is depends on how it’s used. If used as directed, unless someone has an allergic reaction to it, there shouldn’t be a problem, at least in the short-term. Still, it’s important to research any substance you are considering using and weigh any potential risks against the benefits.
Suboxone Abuse and Addiction
Medications like Suboxone don’t do much for people who have already been abusing opioids, but they still have the potential to create a morphine-like high in those who have never taken a similar opioid before. The problem with giving out these medications as take-home prescriptions is that the individuals who receive the prescriptions can give others those pills, even though doing so is illegal. Both parties might assume that buprenorphine is safe and nonaddictive due to the fact that it’s given out by medical professionals. Then, before they know it, someone else is addicted to an opioid.
Even doctors are underestimating the scope of the growing prescription drug abuse epidemic, with 56 percent believing that only a small number of their patients abuse their prescribed medications, according to the American Pain Foundation.
Like any drug, Suboxone can also be abused by mixing it with other intoxicants. Those who obtain a buprenorphine prescription should not be able to experience a euphoric high even if they take more than prescribed, but there is always the potential to use an opioid with other drugs in order to intensify the effects of any of the substances. Doing so significantly increases the potential for serious health problems, including overdose.
However, Suboxone and similar medications do come with some protection from abuse and addiction. Suboxone contains naloxone as well as buprenorphine, which activates when the pill is crushed in order to be snorted or injected. This substance then blocks opioid receptors, preventing the buprenorphine from working as it should, causing withdrawal symptoms.
Signs of Suboxone abuse include:
- Poor coordination
- Poor memory
- Mood swings
- Erratic behavior
- Small pupils
Abuse does not always lead to addiction, but it does increase the chances of both psychological and physical abuse developing. Once someone cannot seem to get through the day without the substance and begins taking serious risks to obtain it, including, in the case of buprenorphine, lying to doctors or going to multiple doctors to get prescriptions, an addiction has likely occurred.
In the case of buprenorphine-based medications, the fact that it is an opioid used to treat addiction has given rise to cash-only buprenorphine clinics that are erected on shifty legal grounds. According to reports, 1,350 out of a total 12,780 buprenorphine doctors have been sanctioned for illegal activity, including over-prescribing, insurance fraud, and practicing medicine while impaired.
The biggest health risk from Suboxone could actually come from not prescribing enough of it. It’s such a hands-off addiction treatment that there is an increased risk of the client going out and finding other drugs to abuse in order to try and get the effect that is craved. Individuals struggling with addiction may end up using other depressants along with the buprenorphine, compounding the depressive effects on the respiratory system. If the respiratory system slows too much, the individual cannot get enough air and could fall into a coma, sustain brain damage, or die of hypoxia.
Common signs of a Suboxone overdose include:
- Significantly slowed breathing
- Blurred vision
- Slurred speech
- Difficulty thinking clearly
- Loss of coordination
- Slowed reflexes
Overdose on buprenorphine tends to be less deadly than overdose on heroin or methadone, but anyone exhibiting these symptoms after taking any kind of opioid should still always seek immediate medical attention.
Over time, any type of opioid will also cause long-term damage to the body. Suboxone is not recommended for people who already have liver problems due to the fact that excessive and/or long-term use of the drug can cause liver inflammation and damage, including a form of hepatitis caused by heavy substance use. If not addressed, the damage to the liver can become permanent and eventually lead to the necessity for a liver transplant if the person survives. Additionally, people taking Suboxone should not operate heavy machinery, and it is not recommended for use by pregnant or breastfeeding women as the opioid will be passed on to the fetus/infant.
The effectiveness and convenience of Suboxone has led it to become a very popular prescription, with sales of the drug reaching $1.3 billion in the US in 2011. However, some people have come to criticize the medication as being too easy to access while still having a potential for abuse and addiction. It’s also come under fire for being mistaken as candy by young children, leading to dangerous overdose and even death. Due to the fact that Suboxone only came onto the market in 2002, there aren’t yet many tested and approved alternatives.
One alternative being tested, currently designated as OX219, is being developed to make it easier for clients to take buprenorphine as directed. It’s basically the same as Suboxone, but it has a better taste and dissolves faster. People on buprenorphine medications often complain about the bad taste of the drug, and something like that can easily serve as a deterrent to taking it at all, risking withdrawal symptoms and cravings that could send individuals back to the original opioid they are trying to break free from. In a clinical trial, 77 percent of those tested said they preferred OX219 to Suboxone.
Despite the hassles associated with methadone, it may be a better option for those who might find it difficult to avoid temptation to take more of a prescribed, at-home drug than directed. It may also make more sense as part of an overall outpatient rehabilitation program that requires an individual to come in on a daily basis for therapy and/or support group meetings, or for urine tests that monitor the levels of other intoxicants in the body. Addiction experts typically highly recommend using a multipronged approach to treatment, as detox alone is not enough to keep an individual from relapsing.
Suboxone is typically safe to take at home if the detox process set out by the doctor is followed. Dangers arise when individuals succumb to temptation and take too much of the medication, mix it with other intoxicants, or fail to take it when they should. Each individual will need to confer with a doctor to determine how high the risk of deviation from the prescription is and whether an alternative would work better.