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Suboxone is an approved doctor-prescribed drug used to treat opioid addiction — with a proven track record of success among patients. It is a combination of the drugs Naloxone and Buprenorphine, prescribed in either Suboxone film or pill form. Both work collectively to simultaneously fight withdrawal symptoms as well as remove opium from the brain's opioid receptors, reversing its effect.

Opioid drugs come from the opium poppy plant. Common types include prescription painkillers, such as oxycodone, codeine, fentanyl, as well as illegal opioid drugs including heroin, and pure opium.

Most successful treatment with Suboxone results in little to no withdrawal symptoms for the patient.

Addiction and dependency

Opioid addiction can be incredibly challenging, as those addicted continue to misuse the drug(s) despite adverse consequences. As a result, they eventually develop tolerance, in which the body requires more of the drug to achieve the desired effect, as well as dependency. Once dependent, a person will experience withdrawal symptoms when they stop taking the drug. Withdrawal symptoms can start within just a few hours.

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Withdrawal

One of the biggest obstacles in breaking the addiction cycle is the withdrawal symptoms that come with dependency and abruptly ceasing the drug's use. Withdrawal symptoms can be unbearable, and many addicted people are highly fearful of the symptoms.

In some cases, withdrawal symptoms can be dangerous. Some of the withdrawal symptoms include:

  • A strong craving for the drug
  • Profuse sweating and clamminess
  • Runny nose
  • Chills and goosebumps
  • Muscle spasms
  • Stomach cramps
  • Homicidal or suicidal thoughts
  • Nausea and vomiting
  • Insomnia
  • Depression
  • Psychosis
  • Agitation and irritability
  • Hallucinations

The following two drugs are combined in Suboxone and work together accordingly:

Naloxone

When opium enters a person's system, the drug attaches to the opioid receptors in the brain, causing a suppression of the central nervous system (CNS). As a standalone drug, Naloxone is the primary go-to drug used to reverse the effect of opium in the brain, as it attaches to the brain's opioid receptors and counteracts the suppression of the CNS.

Hence, Naloxone is included in Suboxone to rid an addicted person of the present opium effects, giving the brain a clean slate as the initial step in their recovery.

Once opium is in the system, it attaches to opioid receptors in the brain. The drug attaches to those receptors and removes the opium, counteracting its effect, essentially restoring a person's mind to normal.

Buprenorphine

Also an opioid agonist, Buprenorphine, is included in Suboxone to significantly reduce or eliminate the harsh symptoms of opioid withdrawal. This drug also has been proven effective in stopping the intense physical craving the body goes through during active withdrawal. It is critical to combating continued drug use and relapse.

Some of the side effects associated with Suboxone include:

  • Chills
  • Fever
  • Light-headedness
  • Cough
  • Profuse sweating
  • Red flushing of the skin
  • Pain in the back or abdomen
  • Nausea and vomiting
  • Issues with concentration
  • Warmth or feeling overheated

Immediate medical attention is urgent in the case of severe side effects, such as:

  • Fainting
  • Rapid or irregular heartbeat
  • Strong disorientation or dizziness
  • Slowed breathing

Certain prescription drugs and herbal supplements are known to have negative interactions with Suboxone and are advised against usage while on the drug. Including:

  • Acetaminophen
  • Benzodiazepines
  • Various HIV medications
  • Rifampin
  • Erythromycin

Also, breastfeeding mothers are strongly advised against breastfeeding while using the drug, as they can pass the drug on to babies through breast milk.

Suboxone is by no means a universal success, as less than 10 percent of all that try to quit fail, and many people run a high risk of relapse. Often, multiple attempts are taken before being able to achieve long-term success.

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Overdose

It is possible to overdose on Suboxone, though it is extremely difficult to do so. Suboxone is only a partial opioid agonist, therefore, there is a limit to how much it can activate opioid receptors. Rare cases of overdose almost always occur when Suboxone is combined with other medicines that suppress the CNS and slow breathing, such as benzodiazepines.

How Suboxone is prescribed

While the drug Methadone serves the same purpose of combating opioid addiction, it is only available at specialty methadone clinics. A doctor may prescribe Suboxone. However, the prescribing doctor must go through an approval process, and patients are required to sign a waiver.

Suboxone is not intended for long-acting opioid patients, but rather, for short-acting opioids such as certain prescription painkillers and heroin.

Additionally, it is not a long-term solution for any opioid addiction. Once the drug has served its purpose of getting a patient to quit, the doctor will continue to monitor the progress of the patient as they progressively reduce the dosage.

Once clean, doctors strongly advise patients to participate in comprehensive treatment programs.

Available Comprehensive Treatment Programs

There are many tools readily available for people to end the vicious cycle of heroin addiction. The first and most crucial step is a desire to quit. While some people can quit on their own, the vast majority of success stories stem from help.

Behavioral therapy is vital to an addicted person's success. Usually, there are underlying issues that lead to somebody falling into addiction, such as depression or PTSD. Some of these long-term support methods may be inpatient or outpatient programs depending on their needs, and include:

  • Motivational Interviews — this method involves a one on one or small group setting to ensure personalized care. The process of dealing with addiction is stressful in and of itself. Therefore, this helps people cope with the process and stay focused on the right path.
  • Contingency Management — this program uses positive reinforcement by giving people tangible rewards for their time spent sober. It uses a "point system" that provides people with a sense of gratification for living a sober life. It is a great way to encourage healthy habits after people have received rehabilitative treatment.
  • Cognitive Behavioral Therapy — The purpose of this therapy is to get to the bottom of issues that may cause people to relapse. To be aware of what their triggers are, maintain realistic expectations, and the stress one goes through while staying sober. Also, it helps to identify specific behaviors that lead to a person acting on their addiction. Included may be outside influence avoidance, as well as internal thought processes.

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Resources

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Pubmeddev. Suboxone versus Methadone for the Treatment of Opioid Dependence: A Review of the Clinical and Cost-Effectiveness - PubMed - NCBI. https://www.ncbi.nlm.nih.gov/pubmed/24716256

Grinspoon, Peter. “5 Myths about Using Suboxone to Treat Opiate Addiction - Harvard Health Blog.” Harvard Health Blog, 20 Mar. 2018, https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496.

LaMotte, Sandee. “Suboxone: What Is It?” CNN, 19 June 2015, https://www.cnn.com/2015/06/19/health/suboxone/index.html.

“Suboxone (Buprenorphine HCl and Naloxone HCl): Uses, Dosage, Side Effects, Interactions, Warning.” RxList, https://www.rxlist.com/suboxone-drug.htm

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