Suboxone is the brand name of a drug containing buprenorphine, a medication designed to help those addicted to opioids achieve recovery.
Opioids like heroin, morphine, and OxyContin are highly addictive. According to the National Survey on Drug Use and Health, 9.9 million people misused prescription opioids in 2018. During the same year, 808,000 Americans used heroin, with 506,000 people falling in both categories.
Opioids block pain and produce an intense euphoric high. Consistent use of opioids–even at therapeutic levels–can quickly lead to significant tolerance and physical dependence. This lays the groundwork for misuse and, ultimately, addiction, as higher doses become necessary to achieve the same effect. Changes in the body and brain as a result of long-term opioid use will produce physical withdrawal symptoms when the individual stops taking the drug.
Medication can assist with managing withdrawal symptoms from opioids. For decades, methadone was the only medication available.
Buprenorphine was approved for use in treating opioid use disorders by the U.S. Food and Drug Administration in 2002. Buprenorphine has been shown to be similarly effective to methadone in suppressing opioid use. It’s also considered safer, as it has a lower abuse potential and a lower risk of overdose.
With methadone, the potential for overdose is so high that those using it to treat their addictions typically have to travel to a hospital or specialized treatment clinic every day for each dose to be administered with physician oversight.
It’s much less to overdose with buprenorphine. This is a primary factor in making it a viable drug for qualified, trained physicians to prescribe to patients to self-administer at home. Suboxone contains naloxone in addition to buprenorphine, which further lowers the abuse potential.
As a partial opioid agonist, buprenorphine produces analgesia and euphoria to a lesser extent compared with heroin and prescription opioids. Its opioid effects eventually reach a ceiling, even if the recommended dose is surpassed. This limits the drug’s tolerance-building and addiction potential.
Buprenorphine also has a high affinity for the body’s opioid receptors, because it blocks them from binding to full opioid agonists. This effectively eliminates the ability for opioids of abuse to produce their euphoric high. When combined with behavioral therapies and a strong support network to prevent relapse, it has helped many people get on the road to recovery.
Medication-assisted treatment for opioid dependency is most effective in combination with psychosocial support. Every person’s needs will differ and it’s important to discuss options for treatment with a qualified healthcare provider.
Risks and Potential for Suboxone Abuse
Drugs like Suboxone are still opioids, but they don’t produce the same kind of high that heroin and morphine do. People seeking opioids for the “high” will not experience it at all if Suboxone is taken as prescribed. Suboxone also stays in the system for much longer. This means that the drug’s tolerance-building and addiction potential are significantly less than they are with more potent opioids. It’s easier to switch from a full opioid agonist like heroin or morphine to a partial opioid agonist like Suboxone when tapering off of opioids completely. Though it’s not always effective, it has helped many people get on the road to recovery.
Buprenorphine is considered a more convenient medication than methadone due to the fact that it does not need to be so strictly controlled. The potential for overdose is so high with methadone 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 don’t have the time or money to travel every day for a dose of a medication.
Suboxone Abuse and Addiction
The fact remains that buprenorphine is an opioid and thus has some potential for diversion, abuse, and even overdose. If used as prescribed and directed by a physician or licensed prescriber, however, it carries little risk of overdose.
There are, however, a number of risks associated with self-administered buprenorphine or Suboxone treatment. Individuals who are prescribed Suboxone can give others those pills, even though diversion of the drug is illegal.
Suboxone can also be dangerous when taken with other medications. It should never be taken in conjunction with alcohol, sedatives, tranquilizers or any illicit narcotic. Doing so significantly increases the potential for serious health problems, including overdose.
Common signs of Suboxone overdose include:
- Significantly slowed breathing.
- Blurred vision.
- Slurred speech.
- Difficulty thinking clearly.
- Loss of coordination.
- Slowed reflexes.
Buprenorphine overdose is typically less deadly than heroin or methadone overdose. Anyone exhibiting these symptoms after taking any kind of opioid, however, should still seek immediate medical attention.
Medication-assisted treatment with Suboxone isn’t appropriate for everyone. It’s not recommended for people who already have liver problems. Additionally, people taking Suboxone should not operate heavy machinery. Pregnant or breastfeeding women should consult with their physician prior to starting Suboxone or any medication-assisted treatment for opioid use disorder.
Suboxone has become very popular because of its effectiveness and convenience. Some people, however, criticize the medication as being too easy to access while still having a potential for abuse, diversion, and addiction.
Suboxone and buprenorphine prescribers are controlled and regulated by the federal government. Despite regulation, there has still been reports of unethical and illegal activity, including over-prescribing, insurance fraud, and practicing medicine while impaired. A 2013 report published by the New York Times found that 1,350 out of a total 12,780 buprenorphine prescribers were sanctioned for this type of activity.
Methadone may be a better option for those who find it difficult to avoid temptation, despite its hassles. An outpatient rehabilitation program that requires an individual to come in on a daily basis for therapy, group meetings, or urine tests may make more sense. Addiction experts typically recommend using a multipronged approach to treatment, as detox alone is not enough to keep an individual from relapsing.
Suboxone is generally safe to take at home if a person follows the medically supervised detox process. Dangers arise when individuals succumb to temptation and take too much of the medication, mix it with other intoxicants, or fail to take it altogether. Each person should confer with a doctor to determine whether an alternative would be more effective.