Great strides have been made in the treatment of addiction. And while suboxone may not be a household name, it is an important component as part of treatment for addiction to heroin or opioids. If you want to know more about this drug, here is a guide to suboxone. We will look at what it is, what it is used for, how it helps, and any concerns in taking it.

What is Suboxone?

Suboxone is the name of the drug buprenorphine. What makes suboxone such a powerhouse is that it is the premier medication that can be prescribed by a physician that doesn’t have to be taken in a structured setting, like a clinic. It works to provide a safe and effective way of helping a person get off of certain drugs like heroin or opioids. It combines two components that work together for a unique treatment. These two ingredients are naloxone (a pure opioid antagonist) and buprenorphine (a partial opioid agonist).

It was approved by the Food and Drug Administration in 2002. It should be used however, along with other types of treatment methods such as behavioral therapies and counseling.

The buprenorphine streamlines a minute dose of opioids to the person taking it. This allows them to taper off of stronger opiate. It also minimizes the symptoms of withdrawal.

An agonist, explains the National Advocates of Buprenorphine Treatment, is a drug that activates certain receptors in the brain. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Examples of full agonists are heoin, oxycodone, methadone, hydrocodone, morphine, opium, and others. 

The naloxone is a strong opioid antagonist. What an antagonist does is to shut down the opioid receptor. This causes it to be blocked from the receptor. Why is this important? By intercepting these signals, it can reverse the effects that are already in the person’s system.

Just so you’re more familiar with antagonists and agonists, according to an article on Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction:

Drugs that activate opioid receptors on neurons are termed opioid agonists. Heroin and methadone are opioid agonists. The repeated administration of opioid agonists results in dose-dependent physical dependence and tolerance. Physical dependence is manifested as a characteristic set of withdrawal signs and symptoms upon reduction, cessation, or loss of an active compound at its receptors. Addiction, conversely, is a behavioral syndrome characterized by the repeated, compulsive seeking or use of a substance, despite adverse social, psychological, and/or physical consequences. Opioid addiction often, but not always, is accompanied by tolerance, physical dependence, and opioid withdrawal symptoms

There are a few examples that are binding to opioid receptors. These include the aforementioned naloxone and naltrexone.

How Does it Work?

The pharmacological properties in suboxone are quite unique. What it does is minimize the potential for misusing opioids, make it safer in case of an overdose, and minimize the withdrawal symptoms and cravings. It actually helps lower the dependency on opioids.

As mentioned, it is an opioid partial agonist. It creates similar effects like opioids such as respiratory depression and euphoria. The difference is that it creates weaker effects than other opioids such as methadone and heroin.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA)

Buprenorphine’s opioid effects increase with each dose until at moderate doses they level off, even with further dose increases. This “ceiling effect” lowers the risk of misuse, dependency, and side effects. Also, because of buprenorphine’s long-acting agent, many patients may not have to take it every day.

Are There Side Effects?

As with any drug, there is the potential of side effects. Yet, the side effects for suboxone are relatively mild. They include:

  • Insomnia
  • Fever
  • Nausea
  • Constipation
  • Vomiting
  • Cravings
  • Cramps
  • Irritability
  • Muscle aches
  • Distress

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What About Misuse?

Due to suboxone having opioid effects, there is a possibility of misuse. This is because of the naloxone that it has in its chemical makeup. The misuse is typically by those without a prior opioid issue. When these products are taken as sublingual tablets, buprenorphine’s opioid effects dominate and naloxone blocks opioid withdrawals. If the sublingual tablets are crushed and injected, however, the naloxone effect dominates and can bring on opioid withdrawals.

Suboxone vs Methadone

A more recognizable name in opioid treatment is methadone. But how do the two differ as far as effects, use, and more?

Methadone is a little different from suboxone in how it works and how it’s made. How it works is that it is a synthetic opioid but not really an opiate. If that’s confusing it is easier explained by it not being made naturally. Opiates use natural components like morphine and codeine – derived from opium. Yet, methadone is created in a laboratory and is man-made. What it does is help with withdrawal symptoms and cravings for opioids like heroin. It is important to understand that while suboxone only treats dependence on opioids, methadone treats that and chronic pain.

It does have a similar way of working, much like suboxone. It binds to the brain’s receptors and helps minimize euphoria from other opioids. This is what makes it more helpful in withdrawal.

As far as suboxone, it is similar too. The naloxone works reverse the effects of opiods. The buprenophine minimizes a person’s urges by acting as a partial opioid agonist as well as blocking opiate receptors. Both components work together to provide a better chance of fewer withdrawals from opioids.

One very important thing to note: Both components work together to provide a better chance of fewer withdrawals from opioids. Suboxone does not treat chronic pain like methadone does.

How is Suboxone Used in Treatment?

Any treatment for opioid abuse should be combined with a professional’s advice and treatment plan. This includes things like detoxification, rehabilitation (both inpatient and outpatient), and support groups. A combination of medication and in-person addiction treatments are paramount in a person being less likely to relapse.

One of the important takeaways is that suboxone is not effective alone in a person’s sobriety. While these are effective aids in getting off of the abuse of opiates, they need to be combined with an effective treatment plan from a professional who deals with substance abuse.

With that said, suboxone can be acquired from a doctor and you do not have to visit a clinic to get it – much like with methadone. This does not mean it is not closely monitored, because it is. It is still a serious drug that your doctor will keep an eye on when you are prescribed it. In some cases, the doctor or their staff will want to watch you take the prescription to ensure it is being taken right and is not kept to store up a stockpile. Or in some cases, to sell.

Some patients are allowed to take their suboxone prescription home but do not expect to get many at one time if you are allowed. Eventually, with proper usage, the monitoring will lessen.