People withdrawing from opioid drugs or medications typically need help dealing with their mental and physical discomfort. Without this kind of help, chances for relapsing back into active substance use can increase dramatically. Suboxone[i] is one of the modern medications used to help people addicted to opioids complete the detox process.

Opioid Withdrawal

Opioid withdrawal[ii] is a likelihood in anybody who develops a diagnosable case of opioid dependence or addiction. In someone with an opioid use disorder, their brain undergoes chemical changes causing them to rely on continued opioid intake. If intake levels fall off or stop altogether, the brain creates withdrawal symptoms as a kind of warning to the rest of the body. When the withdrawal or detox process first gets under way, common side effects include:

  • Sleeplessness
  • Increased feelings of anxiety
  • Increased feelings of mental agitation
  • Aching muscles
  • Increased production of mucus and tears
  • Increased sweat production

As detoxification progresses, other symptoms may appear such as:

  • Nausea and vomiting
  • Loose stools
  • Pupil dilation
  • Stomach cramps

While opioid withdrawal doesn’t come with the same fatality risks associated with certain other forms of withdrawal, it’s uncomfortable enough to promote a return to substance use in many people who don’t receive proper help and support.

Suboxone

Suboxone is brand-name product composed of two distinct medications, buprenorphine and naloxone, and is often prescribed to treat opioid dependence. Buprenorphine belongs to the opioid family but doesn’t produce a drug effect equal to opioid heavyweights such as heroin, oxycodone or fentanyl. Naloxone is actually an anti-opioid medication designed to stop opioid substances from changing normal brain function.

Suboxone comes in the form of a sublingual or buccal film. When placed under the tongue (sublingually) or against the wall of the cheek (buccally), it dissolves and releases buprenorphine and naloxone into the bloodstream.

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Buprenorphine’s Impact

While buprenorphine is a relatively weak opioid, it still produces a substantial impact on the brain and body. In a person accustomed to consuming stronger opioids, it typically does not have the power to trigger a “high.” However, during the withdrawal process, buprenorphine is potent enough to help reduce discomfort and make it easier to complete opioid detoxification.

Naloxone’s Impact

When administered on its own in the form of an injection or nasal spray, naloxone[iii] quickly halts the brain and body effects of opioid substances. For this reason, the medication is now a first choice for reversing the symptoms of opioid overdose. However, when used in the right proportions in combination with buprenorphine, naloxone’s impact changes. Instead of immediately interfering with the effects of opioids, the medication acts as a kind of opioid limiter. At a predictable rate, it gradually cuts off the effects of buprenorphine. In this way, naloxone places a ceiling on buprenorphine’s actions.

Why Are Buprenorphine and Naloxone Used Together?

Despite its lack of potency compared to other commonly abused opioids, buprenorphine is still an opioid substance. This means that, inevitably, some of the people going through opioid detox will be tempted to abuse the medication and use it to get high. In addition, people not used to consuming opioids can potentially turn to buprenorphine as their initial target for opioid abuse.

The act of combining buprenorphine and naloxone addresses both of these risks. People going through detox will generally be less likely to abuse Suboxone when they realize the medication has a built-in limit on its effects. Non-addicted people with access to the medication will fail to achieve the intense highs that often encourage an addictive pattern of use.

When Does Suboxone Treatment Begin?

Suboxone treatment does not usually begin immediately when a person begins opioid detox. Instead, guidelines call for doctors to wait until moderate symptoms of withdrawal start to occur. The reason for this is because use of the medication at an earlier stage can actually worsen the symptoms of withdrawal. The window for administration of the first dose of Suboxone opens roughly six hours after the last dose of an abused opioid is consumed.

Who Receives Suboxone During Opioid Detox?

Not everyone who goes through opioid detox will receive Suboxone as a treatment. In a person accustomed to the effects of a long-acting opioid such as methadone or an extended-release medication, use of Suboxone can potentially make withdrawal symptoms worse. In addition, it can make those symptoms last for a longer period of time. For these reasons, people addicted to long-acting opioids are usually better suited for the use of a buprenorphine product that does not contain naloxone. Suboxone is generally suitable for people accustomed to the effects of short-acting opioids such as heroin and non-extended-release medications.

When Does Suboxone Treatment End?

Doctors decide when to end Suboxone treatment on a case-by-case basis. Use of the medication may end prematurely for any one of several reasons, including:

  • A toxic reaction to the medication’s effects
  • A lack of evidence for the effectiveness of treatment
  • A return to active opioid abuse while taking Suboxone
  • A failure to comply with other aspects of treatment while taking Suboxone

If treatment goes well, doctors will gradually reduce the dose of the medication as the withdrawal process takes its course. The objective is to leave a person who takes Suboxone opioid-free and ready to take part in an active addiction treatment recovery program.

Programs for Opioid Abuse and Addiction

Ideally, a person who completes opioid detox with the help of Suboxone will immediately enroll in a program equipped to deal with the short- and long-term effects of opioid abuse and addiction. In addition to continuing use of some form of medication, treatment in such a program commonly includes behavioral therapy or psychotherapy[iv].

If you or your loved one are affected by opioid use disorder, the professionals at Transformations Treatment Center are here to help. We get you started in a treatment program that follows best practices for opioid treatment. Every client receives truly personalized care that’s designed to identify specific barriers to recovery and provide appropriate steps for overcoming those barriers.

  1. U.S. National Library of Medicine – DailyMed: Suboxone https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8a5edcf9-828c-4f97-b671-268ab13a8ecd
  2. U.S. National Library of Medicine – MedlinePlus: Opiate and Opioid Withdrawal https://medlineplus.gov/ency/article/000949.htm
  3. National Institute on Drug Abuse: Opioid Overdose Reversal with Naloxone (Narcan, Evzio) https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio
  4. National Institute on Drug Abuse: Treatment Approaches for Drug Addiction https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
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