According to the 2018 National Survey on Drug Use and Health, 9.9 million Americans misused prescription opioids and over 8,000 used heroin. An estimated 2.0 million Americans have an opioid use disorder.
When an individual develops a dependence on opioids and wants to quit, stopping abruptly isn’t an option. Opioids affect the chemistry of the brain, and stopping them suddenly can result in withdrawal symptoms that have potentially life-threatening complications.
The U.S. Food and Drug Administration has approved three medications used in medication-assisted treatment for opioid use disorders: methadone, buprenorphine and naltrexone.
Buprenorphine is a partial opioid agonist that has a high affinity, but low intrinsic activity at the body’s opioid receptors, meaning that it displaces other opioids while having a less intoxicating effect.
What is Suboxone?
Suboxone is the brand name for a medication that contains buprenorphine and naloxone, and doctors typically prescribe it to patients who are trying to kick an addiction to opioids.
Using Suboxone to quit opioids safely is not simply replacing one addiction with another, and when coupled with therapy, medication-assisted treatment can be effective and result in recovery; however, it is still possible to develop a physical dependence on, and even an addiction to, Suboxone, especially if an individual doesn’t use it according to a doctor’s recommendations.
The American Society of Addiction Medicine reminds readers that there’s a very real difference between addiction, dependence, and tolerance.
Addiction is a chronic neurobiological disease that can occur due to environmental, genetic, or psychosocial factors. It is characterized by impaired control due to drug use and marked by compulsive behaviors, intense cravings, and continued use of the substance despite the harm it might cause.
Suboxone helps opioid-addicted individuals maintain a dependency to opioids while inhibiting the user from getting high, even at higher doses. This is because buprenorphine reaches a ceiling where higher doses do not increase the drug’s effect.
Suboxone can be an effective way for people to taper off opioids, but that’s not the only reason why doctors prescribe it. Physicians also increasingly prescribe Suboxone off-label for management of chronic pain and it’s also being studied for the treatment of depression. Like other opioids, Suboxone is an effective medication for pain relief.
Although typically used alongside cognitive therapy to treat addiction, Suboxone is still an opioid and therefore carries with it a potential for abuse. It is possible to develop a tolerance of and dependence to Suboxone itself, which means that a person will experience withdrawal symptoms if they stop taking the medication.
If a loved one appears to have developed a dependence on Suboxone, medically supervised withdrawal management is needed to wean the individual off the medication. Though it’s natural to feel nervous about going through the process of detoxification, doing so with the help of healthcare professionals can ease some of the discomfort and ensure your safety.
Symptoms of Withdrawal
The duration and intensity of Suboxone withdrawal varies among users and ultimately depends on the intensity of their addiction; however, there are generally a few constants when it comes to withdrawal. Symptoms typically last for a few weeks, and the physical symptoms gradually get less severe over time. Some common symptoms of Suboxone withdrawal are:
- Muscle aches
- Fever or chills
- Difficulty concentrating
Just as the symptoms experienced vary for everyone, so does the timeline. There are, however, some general phases that most people going through medical detox can expect:
- 72 hours after last dose: Physical symptoms peak.
- Within 1 week after last dose: Body aches and pains, mood swings, and insomnia are experienced.
- 2 weeks after last dose: Feelings of depression develop and may last up to 1 month.
- Up to 1 month after last dose: Cravings are experienced; they will ultimately diminish with time.
Though the above are common withdrawal symptoms, there’s no way to predict how someone’s body will react before withdrawal begins. For that reason, undergoing medical detox can be an effective way to manage symptoms.
During medical detox, individuals have access to a dedicated healthcare staff 24/7, and they are trained to act in medical emergencies.
Going through withdrawal may be uncomfortable, but it’s entirely possible to come away unscathed and ready to face the world with newfound sobriety.
Complications of Suboxone Withdrawal
Despite the fact that Suboxone is often used to help people overcome addictions to powerful opioids, it’s still an opioid itself, and complications can arise while using it as well as when trying to taper off of it. Emergency room visits that involved buprenorphine increased from 3,161 in 2005 to 30,135 in 2010. About 13% of the visits was due to adverse reactions and 52% were for nonmedical use. This underscores the importance of medically supervised withdrawal management. Clients who experience any complications during withdrawal will have access to a team of medical professionals who will ensure their comfort and safety and manage any severe complications that might arise. In most cases, though, severe complications are not a major part of the opioid recovery process.
If a loved one is showing signs of addiction or misuse of Suboxone (or buprenorphine), the first step is to enroll them in a medical detox program. Following detox, inpatient programs incorporating various types of therapy can be effective at navigating individuals toward sobriety. Completion of an inpatient program may be followed by an outpatient program, which can be an effective way to help a loved one ease back into everyday life slowly while acquiring the tools needed for long-term recovery.