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Suboxone Addiction

Although Suboxone is widely-used as part of medication-assisted treatments to help people reduce or quit their use of opiates and counter opioid overdose, it also carries with it the potential for suboxone addiction among its users. Suboxone is commonly prescribed in pill form to patients, making it easier to distribute than some earlier medication-assisted treatments. Like many prescription medications, suboxone is actually a combination of drugs – in this case: buprenorphine (an opioid partial agonist) and naloxone (a pure opioid antagonist). Each of the constituent components of suboxone has its own role in treating individuals with opiate addictions, and the combination of these two specific drugs was designed to limit the potential for Suboxone addiction and abuse. Unfortunately, as is the case with many other “safer” opioids developed throughout history, the buprenorphine component of Suboxone can make it addictive in the same way as other drugs such as heroin or hydrocodone. [1] [2]

illustration of a suboxone capsule

Naloxone Usage

Naloxone was developed to reverse the toxic effects of opioid overdoses by blocking the opioid receptor sites in an individual’s body. By blocking these receptor sites, naloxone prevents the opioid from binding with them, immediately stopping the “high” of opioid abuse. Due to this effect, naloxone is now used as an emergency treatment in the case of opioid overdoses by first responders and, where legal, by laypersons with the auto-injector that was approved for use in 2014. Naloxone is so effective in blocking the effects of opioids in an individual’s system that it often provokes a violent response by the opioid addict who finds themselves suddenly “sober” and almost immediately beginning to experience withdrawal symptoms from their opiate of choice. [2]

photo of a young man who overdosed and is being given Naloxone by paramedic

The Role of Naloxone in Suboxone

Naloxone is included in Suboxone as a means to prevent abuse of the partial opioid buprenorphine in suboxone, as well as that of other “full” opioids such as heroin. Naloxone is added to the buprenorphine to lessen the “high” it creates, making suboxone less likely to be diverted from medical usage into “street” usage as a substitute for other opioids. However, this does not mean that suboxone is not addictive; it is and can result in a suboxone addiction among its users. It is arguable that this addiction is less dangerous than an addiction to heroin or other full opioids, but it is an addiction nonetheless, carrying with it the potential for painful withdrawal common to all opioids.

Buprenorphine Usage

As the first medication approved to treat opioid dependency that can prescribed from a doctor’s office, buprenorphine has significantly increased treatment access to large numbers of opioid addicts. One of the benefits of buprenorphine is that it has a “ceiling effect” to the high it creates in users, lowering the potential for misuse, dependency, or side effects. However, it still has opioid effects, making it possible to abuse and become addicted to over time. Some of the side effects of buprenorphine are also similar to other opioids, such as:

 

  • Nausea, vomiting, and constipation
  • Muscle aches and cramps
  • Cravings
  • Inability to sleep
  • Distress and irritability
  • Fever [1]

The Role of Buprenorphine in Suboxone

Buprenorphine is included in Suboxone to moderate the withdrawal symptoms that users would otherwise experience when abruptly ending their usage of other opioids such as heroin. As mentioned previously, if suboxone contained only the naloxone component, users would be protected from the effects of other opioids, but they would also experience a “crash” from the sudden ending of their opioid high which would bring on the painful effects of withdrawal almost immediately. Buprenorphine eases this transition by substituting a partial opioid agonist (buprenorphine) for the full opioid agonist (e.g. heroin) they are trying to quit using. This makes the recovering addict much more likely to “stick with the program” and refrain from returning to their prior opioid usage in an effort to relieve the symptoms of withdrawal.

illustration showing four different color buttons and a person pushing the one labelled Suboxone

Suboxone Treatment or Suboxone Addiction?

Although Suboxone has been shown to be effective in getting addicts to stop taking their original opioid of choice, its use often results in essentially trading one addiction for another. It can be argued that a Suboxone addiction is less dangerous than one to heroin or other prescription opioids, but it is an addiction nonetheless. Due to the less powerful “high” produced by suboxone, it can make its users much more functional on a day-to-day basis, but they are still trapped by the chains of addiction, albeit to a less dangerous drug than before. Is this success or genuine recovery from addiction? It seems like a partial success at best, particularly when one considers all of the negative effects of a suboxone addiction.

Side Effects, Drug Interactions and Withdrawal Symptoms of Suboxone

There are numerous negative consequences to taking suboxone on a regular basis. These include both common and serious side effects, potentially dangerous drug interactions with many medically necessary drugs, and withdrawal symptoms if the individual eventually decides to end their usage of suboxone. Each of these, in and of themselves, should make anyone seriously consider whether suboxone is the best way to end their addiction to other opioids.

Suboxone Side Effects

Common

  • lightheadedness
  • dizziness
  • fainting
  • sleepiness
  • nausea and vomiting
  • sweating
  • constipation
  • numbness in your mouth
  • swollen or painful tongue
  • redness inside your mouth
  • trouble paying attention
  • faster or slower heart rate
  • blurry vision

Serious

  • addiction
  • severe breathing problems
  • problems with coordination
  • allergic reaction
  • opioid withdrawal
  • low blood pressure
  • liver problems [3]

Drugs with Negative Interactions with Suboxone

  • benzodiazepines such as alprazolam, lorazepam, and clonazepam
  • sleep aids such as zolpidem, eszopiclone, and temazepam
  • anesthesia medications
  • other opioids
  • antifungal medications such as ketoconazole, fluconazole, and voriconazole
  • antibiotics such as erythromycin and clarithromycin
  • antiseizure drugs such as phenytoin, phenobarbital, and carbamazepine
  • HIV drugs such as zidovudine, efavirenz, and ritonavir [3]

    Suboxone Withdrawal Symptoms

    • cravings
    • trouble sleeping
    • diarrhea
    • nausea and vomiting
    • depression and anxiety
    • muscle aches
    • fever, chills, and sweating
    • headache
    • trouble concentrating

    How Effective is Suboxone Alone?

    Considering the potential for individuals to develop Suboxone addiction or suffer from the various side effects and possible drug interactions of this drug, it is fair to look at just how effective Suboxone is at getting individuals to become opioid-free without the addition of other treatment methods such as inpatient rehab or 12-step programs. In a study conducted from 2003 to 2005 involving participants from 11 outpatient programs in 10 US cities, opioid addicts were given Suboxone (and subsequently “tapered-off” of it in 7 or 28 day periods) in an attempt to end their opioid usage purely through the use of this drug, without any other drug treatment therapies. At the end of 3 months, only 12% and 13% of participants (from the 7-day taper and 28-day taper groups respectively) tested negative for opioids. This extremely low result illustrates that Suboxone is far from being a “miracle cure” for opioid addiction, particularly when other forms of drug treatment are not included in the addict’s treatment.

    illustrated piechart showing Suboxone is only effective 12.5% of the time without drug treatment

    Treating Suboxone Addiction

    As more individuals are given Suboxone as a “treatment” for their addictions to other opioids due to its relatively low cost when compared with more intensive drug treatment, many unfortunately find themselves in the grip of suboxone addiction instead. Rather than being a “cure” for their addiction, Suboxone usage becomes a drug maintenance regime, similar to how methadone has been used for decades. If these individuals want to end their Suboxone addiction, they need to find a more effective approach rather than simply substituting one opioid for another. Research has shown that inpatient drug rehab at a reputable facility is the most effective way to ensure a long-term, drug-free lifestyle for anyone who has fallen prey to the cycle of addiction – whether it is “on the streets” or under a well-meaning physician’s care.

    Put All Opioids in your Rear-View Mirror

    If you or a loved one has tried Suboxone to end your opioid addiction only to replace it with an addiction toSuboxonee, you need to try a different approach – one that can make you completely opioid-free and in charge of your own destiny again. The first step in regaining control of your family’s future is calling BWR at 800-683-4457. Our operators are on-call 24/7 to help you get started on the path to real recovery today.

    "THE GOLD STANDARD IN CARE"

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    "THE GOLD STANDARD IN CARE"

    Behavioral Wellness & Recovery is a Joint Commission accredited program. The Joint Commission recognizes excellence in health care organizations and programs.

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