Suboxone is the brand name for a medication that contains the opiate buprenorphine and the narcotic antidote naloxone. Although its opiate content means that Suboxone can relieve pain, this is not its intended purpose and it is instead prescribed to help treat opiate addictions. According to the FDA, Suboxone offers an alternative treatment to methadone, which is only available from specialist addiction centers, widening access to opiate substitution therapies as not everyone dependent on opiates can receive treatment at a dedicated drug rehab facility. Suboxone is therefore prescribable by a physician at their own practice, but while this medication increases the chances of success during the maintenance phase of opiate addiction treatment, it is most likely to be effective when taken in combination with a program of specialist counseling. You are able to take a supply of prescribed Suboxone home with you, as it is considered less likely to be abused than methadone and the risk of overdose is much lower, but you should still be aware of the possible adverse effects associated with its use and the fact that it is potentially addictive.
As methadone usually comes in liquid form, you may wonder how you take buprenorphine. Suboxone comes as a film that you place under your tongue to dissolve, which explains what is suboxone strips, as the medication is sometimes referred to. Once the active ingredient buprenorphine enters your bloodstream, it binds to opiate receptors in your brain, helping to reduce the unpleasant effects of drug withdrawal and although it can still induce a high, as the SAMHSA discusses, at lower doses this is minimal. The naloxone component is present to deter the injection of Suboxone, as it doesn’t enter your bloodstream via your tongue, but it will block opiate receptors on injection leading to unpleasant withdrawal symptoms.
Buprnorphine on its own, sold under the name Subtrex, is the treatment of choice during an inpatient opiate detox, as this is less likely to trigger withdrawal symptoms owing to the absence of naloxone. However, as Government guidelines on the use of buprenorphine explains, Suboxone is preferred in the outpatient setting, as the naloxone content deters addicts abusing other opiates, which is more likely when receiving non-residential treatment. While the risk of withdrawal symptoms remains in the presence of naloxone, when taken as prescribed, this is less likely.
When used as an opiate maintenance therapy, your physician will aim to establish the correct dose to stabilize you as soon as possible and make sure that you receive the medication in combination with addiction counseling to reduce your risk of relapse. It usually takes between a week and ten days to determine the correct dose for opiate maintenance and after one month of compliance you will be issued with a weekly prescription for Suboxone. The prescription you are able to take home with you will increase gradually till four months compliant when you will be able to receive a month supply of Suboxone at a time.
While Suboxone is an effective treatment for opiate dependency, if you suffer from a condition where pain is one of the symptoms, this can influence the maintenance therapy you receive. When the pain is acute, your doctor will encourage you to take non-narcotic painkillers alongside your buprenorphine therapy. However, as burprenorphine is an analgesic, under their supervision they may recommend an increased dose of Suboxone or treatment with other opiate painkillers if this approach is not effective. However, when it comes to chronic pain, buprenorphine is not an effective opiate maintenance treatment, as over time a “ceiling effect” occurs with pain management, making methadone a more suitable choice.
Suboxone Strips Side Effects
When taking Suboxone to treat opiate dependence there is a chance you may develop unwanted secondary effects, just like with any other prescription medication. According to a database of treatments, some of the most common Suboxone side-effects that you are likely to experience are a cough, dizziness, high temperature, sweating and headaches, though swelling, weight changes and a tingling sensation in your extremities may also occur. While these are generally mild, if you experience more significant symptoms such as abdominal pain, digestive upset, reduced muscle strength or insomnia, you should discuss this with your Suboxone doctor. In the case of Suboxone abuse, an overdose is more likely, in which case you risk the following adverse effects:
- Blurred vision and pinpoint pupils
- Feeling dizzy and weak
- Drowsiness and confusion
- Difficulty breathing and signs of oxygen depletion such as blue lips or finger nails
As buprenorphine is an opiate, some people may try to abuse Suboxone to achieve feelings of euphoria, just as they may other opioid drugs. Buprenorphine use triggers feelings of pleasure, as by binding to opiate receptors in the brain this raises dopamine levels, one of the brain’s feel-good signaling molecules. However, as buprenorphine is only a partial opioid agonist, the euphoric effects are not as great as that achieved by using the likes of heroin or morphine. Similarly, the presence of naloxone deters IV drug users injecting Suboxone, but people who are not yet in the grip of opiate dependency may choose to take sublingual Suboxone strips, seeing it as an easy way to obtain a high. With repeated use of this buprenorphine and naloxone therapy it is possible to develop a dependency on the opiate component.
With buprenorphine dependency you will find that if you go some time without the drug that you develop signs of Suboxone withdrawal. While withdrawal symptoms for Suboxone are milder than those experienced with some other opiates, you may still experience problems such as anxiety, fever and chills, muscle aches and tremors if you try to come off the drug. You will also find that with dependency you develop a tolerance to Suboxone, so need to take increasing doses to achieve the same effects, which increases the likelihood that you will become addicted. If you are concerned about your use of Suboxone, it is essential you seek treatment so that you can comfortably withdraw and start a program of addiction therapy to kick your Suboxone habit.
Image Credit: http://bit.ly/1xiTy6z