- Addiction & recovery
What is Suboxone?
July 21, 2021
Suboxone is a combination medication of buprenorphine/naloxone approved by the U.S. Food and Drug Administration (FDA) to treat opioid use disorder (OUD). According to the American Psychiatric Association (APA), opioid use disorder is the misuse of opioids that causes significant distress and impairment. Opioid misuse is a broad phrase that encompasses any case in which opioid use deviates from prescribed guidelines; this can range from a simple misunderstanding of instructions to self-medication for other symptoms to compulsive use caused by an opioid use disorder.
Opioids, sometimes known as narcotics, are pain relievers prescribed by healthcare providers to manage chronic or severe pain. Opioids bind to proteins on nerve cells in the brain, spinal cord, gut, and other body regions called opioid receptors. This function causes opioids to block pain signals passed from the body to the brain via the spinal cord. Opioids have some drawbacks and can be highly addictive, even when used as prescribed. When opioids are used to treat chronic pain over a long period, the risk of addiction is very high.
The adverse consequences of opioid use disorder are far-reaching. Since the 1990s, the rising prevalence of OUD and opioid overdose mortality has reached epidemic proportions. According to the Centers for Disease Control and Prevention (CDC), approximately 500,000 individuals died from an opioid overdose, including prescription and illegal opioids, between 1999 and 2019.
Suboxone medication for opioid use disorder (MOUD) is considered a feasible pharmaceutical alternative to methadone due to its low risk of misuse, overdose, and side effects.
What Is Suboxone Used for and How Does It Work?
Suboxone (buprenorphine/naloxone) works by binding to the same opioid receptors in the brain as opioids like heroin, morphine, and oxycodone, thereby blunting intoxication. This blunting prevents opioid cravings and helps people maintain sobriety during their recovery process.
Suboxone is made up of two compounds known as buprenorphine and naloxone in a 4:1 combination. The main active element, buprenorphine, is a partial agonist and a long-acting opioid. Naloxone, the second component, serves to counteract the effects of opioids and prevent the risk of misuse. Both medications act together to decrease opioid withdrawal syndrome associated with opioid dependence.
Suboxone offers more freedom of administration than other medications since they’re prescribed in an outpatient setting. Suboxone is a medication that helps individuals safely and efficiently overcome and manage opioid withdrawal syndrome.
How Suboxone Is Taken
Suboxone is taken either as sublingual tablets or films. The tablet is placed under the tongue, while the film is placed between your gums or cheek to dissolve (buccal). Suboxone film is more popular than tablet form because it dissolves faster.
The starting dose of Suboxone depends on factors such as:
- Type of opioid used
- Timeframe of the last dose
- Level of dependence
Suboxone films disintegrate after 4–8 minutes when placed under the tongue. After placing the film beneath the tongue, do not swallow or chew; doing so reduces its effectiveness. Suboxone starts to take effect 30 to 60 minutes after administration, and the effects can last for 48 to 72 hours (if you’ve found the right dose).
Things to Remember When Taking Suboxone
- Missing Suboxone doses can make the medication less effective. If you forget to take a dose, do so as soon as you remember. If your next dose is approaching, however, forgo the missing dose. Do not double dose to compensate for the missed dose. Only take the dose that has been prescribed to you. If you’re unsure, talk to your doctor.
- Suboxone can only be prescribed through the Suboxone REMS Program by doctors who meet specified criteria and have been given a unique identification number that is included on every prescription.
- Suboxone may not be a viable medication for people with head injuries, acute abdominal conditions, or preexisting respiratory diseases such as COPD and asthma. Please consult with a prescribing practitioner prior to starting Suboxone if you have any of the conditions listed above.
- Sudden discontinuation of Suboxone can cause withdrawal symptoms. Individuals who want to discontinue taking the drug should consult with their doctor beforehand.
- Certain medications can increase the sedative effects of Suboxone. Inform your doctor of all medications currently in use before Suboxone treatment.
- Other brands of buprenorphine/naloxone are not interchangeable with Suboxone (for example, Suboxone sublingual tablets require a different dose than Bunavail buccal film). When switching brands, keep an eye out for indicators of overmedication, withdrawal, or underdosing.
Side Effects of Suboxone
Suboxone may cause side effects that can range from mild to severe. Some of these side effects may subside in a matter of days or weeks. The most common side effects of Suboxone include:
- Nausea and vomiting
- Muscle aches
- Abdominal cramps
- Irregular heart rate
- Weakness or fatigue
- Burning tongue
- Redness in the mouth
- Blurry vision
If common side effects persist or worsen over time, consult your physician immediately.
Serious side effects of Suboxone can include:
- Severe allergic reaction
- Capacity to cause dependence
- Breathing problems
- Hormone problems (adrenal insufficiency)
- Liver damage
- Severe withdrawal symptoms
Serious side effects of Suboxone are rare. However, if you experience any of the following symptoms, contact your physician immediately.
Allergic Reaction to Suboxone
Suboxone can cause severe allergic reactions, including anaphylaxis in certain individuals. If you experience any of the following symptoms, contact your doctor or get emergency help immediately. Allergic reactions to Suboxone may include
- Trouble breathing
- Swelling of lips, tongue, or throat
- Skin rash or hives
Can You Overdose on Suboxone?
Suboxone is designed to be tamper-proof by design. For this reason, it contains both buprenorphine and naloxone, the latter of which is routinely used in medical emergencies to counteract opioid overdoses. Suboxone’s chemistry offers built-in overdose prevention in numerous ways. However, overdose is a possibility if the medication is administered incorrectly or in conjunction with other sedatives.
Symptoms of a Suboxone overdose may include:
- Nausea and vomiting
- Abdominal pain
- Loss of physical coordination and appearing drunk or drugged
- Slowed heartbeat
- Irritability, anxiety, and mood swings
- Trouble concentrating or remembering things
- Depressed breathing
Individuals who exhibit abnormal behavior or symptoms after using Suboxone, as with any opioid overdoses, should seek medical attention as soon as possible.
Withdrawal Symptoms of Suboxone
Despite its effectiveness, Suboxone can cause dependence and withdrawal symptoms. Suboxone withdrawal usually starts within 2-4 days, peaks within 3-5 days, and dissipates by the end of the week. Suboxone withdrawal symptoms are comparable to milder versions of other opioids. The following are some of the most common withdrawal symptoms:
- Muscle pain
- Body ache
- Drug craving
- Difficulty concentrating
Abrupt cessation of Suboxone treatment can cause withdrawal symptoms. Hence if you wish to stop using Suboxone, consult your doctor beforehand.
The Benefits of Suboxone
Suboxone treatment is beneficial for individuals who are battling opioid addictions. Relief from cravings and withdrawal symptoms helps individuals in recovery actively participate in other components of OUD treatment, including behavioral therapy and social support groups. Suboxone is useful in MOUD therapies for weaning people off opioids and reducing the need for inpatient detoxification.
The main benefits of Suboxone include:
- Fewer cravings for opioids
- Suppression of opioid withdrawal symptoms
- Reduced risk of relapse
- Low risk of misuse
Other specific advantages of Suboxone are:
- A high rate of success: According to the National Institute on Drug Abuse, those who took Suboxone had a 49% lower use of prescription opioids than those who didn’t use Suboxone. However, this number decreased to just over 8% when Suboxone was withdrawn.
- Convenient: Rather than coming in for treatment daily or staying at residential facilities, a physician can prescribe the medication, which you then take to your regular pharmacy to be filled.
- Affordability: Cost-effectiveness. Most programs can help you file insurance claims by providing visit and payment documentation, as well as assisting you in applying for prescription assistance programs.
Abstinence-based addiction treatment that has dominated for over a century is giving way to comprehensive treatment methods. These include medications like Suboxone used together with counseling and therapy. Talk to your doctor about Suboxone treatment and how it can benefit you in your recovery process.
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