An opioid is a chemical that binds to opioid receptors, located in the brain and spinal cord and the gastrointestinal tract. Opioids produce natural painkillers, like endorphins, and can be derived from the poppy plant (opium) or manmade, such as codeine. Opioids are commonly abused and opioid addiction is now recognized as a treatable medical disorder of the central nervous system. Widely abused opioids are oxycodone, hydromorphone and hydrocodone, and pharmaceutical names include OxyContn, Vicodin, Percocet or Lortab.

When frequently exposed to certain chemicals, especially those found in illicit drugs like opiates, the body tries to maintain a sense of balance. When this balance is disrupted because the drug is removed, the symptoms of withdrawal occur. It’s difficult to clearly determine how many Americans are currently experiencing drug withdrawal, but the number may approach 4 million.
For many users, the opiates bring a sense of euphoria and have a tranquilizing effect. However, over time, people who abuse opiates will experience a stopping of endorphin production. This is caused by damage to the brain’s nerve cells. Eventually the user becomes dependent on the opiates to produce endorphins because the body can no longer carry out the task. Many patients feel unable to stop abusing the drug because of extreme cravings and its addictive nature.

Patients seeking treatment for opioid abuse may present similar symptoms as other mental disorders, making a clear diagnosis challeging. Withdrawal may seem like a bad case of influenza: sneezing, fatique, diarrhea or vomiting. Leg or abdominal cramps, chilling or goosebumps and pupil dilation may also be present. Though violent mood swings and anxiety may occur, unlike other drug withdrawal symptoms, hallucinations and seizures are not likely to occur.

Withdrawal length varies based upon type of opioid used. Heroin withdrawal may last up to ten days and peaks between 36 hours and three days. For methadones, withdrawal can last two weeks and peaks at around 72 to 96 hours. Patients recovering from opiate addiction may also be at higher risk for HIV or illnesses connected to AIDS, such as pneumonia.

In 1997, the Waismann Method of Accelerated Neuro-Regulation was developed and has treated thousands of patients successfully. During this hospitalized treatment, medications are administered to flush the opiate receptors while the patient is asleep under mild anesthesia. Typically, patients will see a faster withdrawal process and can be released in less than a week. Follow-up treatment includes drugs to stop the body’s cravings for opiates under careful observation.

Due to potentially life-threatening health risks, experts recommend opiate addicts recover in a professional detoxification program under medical care, preferably certified for addiction recovery. Most patients will also need further treatment once detoxification has been completed. Due to the highly addictive nature of the drugs, many may return to the opiates for a second cycle.

Opiate Withdrawal Syndrome Recognized as Medical Disorder is a post from: Drug Addiction Treatment

Dr. Sack explained that Suboxone is one of two forms of the medication buprenorphine, which was originally developed to treat pain. Suboxone binds to the opiate receptor in the brain and suppresses pain in the same way that opiate drugs like morphine, heroin, and other opiates do. However, as the dosage increases, Suboxone blocks the opiate receptor and doesn’t allow it to be stimulated. Unlike Subutex, the other form of buprenorphine, Suboxone contains naloxone, which blocks the effects of opiates when injected intravenously.

Put simply, Suboxone acts like other opiates but blocks the level at which someone can experience euphoria, making it impossible for someone to get high from other opiates like OxyContin, heroin, codeine, morphine, and Vicodin. This way, clinicians can use Suboxone to block the withdrawal symptoms without having to worry about the client relapsing. In addition, the naloxone prevents people from getting high on Suboxone by injecting it rather than taking it sublingually.

Dr. Sack explained that 25 to 30 percent of Promises clients are dependent on opiates and that about two-thirds of those clients also abuse other drugs. At Promises, Suboxone is usually used for 3-4 days, but can be used for up to 14 days depending on the severity of the dependence. Once a person starts exhibiting withdrawal signs, he or she is given Suboxone and the withdrawal symptoms are stopped within 12-15 hours.

When asked if Suboxone itself is addictive, Dr. Sack said, “Drugs that have the greatest addiction potential have short half-lives and are absorbed quickly into the brain. Suboxone has a very long half-life and takes a while to reach the brain, so it has a much lower addiction potential. People can and do take Suboxone recreationally, but doctors just need to manage people to make sure they use it correctly. In addition, the euphoric feelings that come with Suboxone are much less intense than other opiates because of its long half-life, so people are less likely to abuse Suboxone.”

Suboxone is approved for maintenance like methadone, but Promises doesn’t use it this way. “For most people who are dependent on opiates and other drugs or alcohol, the goal of recovery is to be off drug completely, so staying on methadone or Suboxone for maintenance kind of defeats the purpose,” Dr. Sack said. He acknowledged that some opiate users will benefit more from maintenance treatment but that the ultimate goal is to get them off of drugs completely.

The advantage of using Suboxone instead of methadone is that if someone does use street drugs while taking Suboxone, it’s very unlikely for that person to overdose. In addition, methadone can only be dispensed from a methadone clinic, and patients must visit the clinic every day to get their dose. Suboxone, however, can be prescribed by a physician.

Of Suboxone’s efficacy, Dr. Sack said, “Data shows that buprenorphine is 50-100% more effective than other available treatments such as clonidine, and that a higher percentage of people who use buprenorphine complete their withdrawal. For maintenance treatment, the results are similar to methadone in that about 60% of people who are given maintenance treatment with buprenorphine stay on the treatment and don’t use illicit drugs while they’re on it.”

Suboxone: Safe, Comfortable Withdrawal from Opiates is a post from: Drug Addiction Treatment

One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.

Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.

There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:

• Headache

• Drowsiness

• Dizziness

• Vomiting

• Decreased libido

• Constipation

• Respiratory depression

Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.

While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.

Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.

Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.

Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.

It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.

The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.

Resource:  Suboxone Treatment

Sources Used

1. Buprenorphine Detox and Treatment. http://www.addictionsearch.com/

treatment_articles/article/buprenorphine-detox-and-treatment_24.

html. Accessed 19 June 2009.

2. Buprenorphine. http://www.answers.com/topic/buprenorphine-hydro

chloride. Accessed 19 June 2009.

Buprenorphine is a post from: Drug Addiction Treatment