Suboxone: Safe, Comfortable Withdrawal from Opiates

Suboxone: Safe, Comfortable Withdrawal from Opiates

Many people find it difficult to stop using opiates because the withdrawal symptoms can be very severe and usually begin within 4-12 hours of the last dose. But at Promises Treatment Centers, opiate-dependent clients are given Suboxone, medication that virtually stops all withdrawal symptoms, making the client significantly more comfortable during the detoxification process. David Sack, MD, Addiction Psychiatrist at Promises Treatment Centers, explains what Suboxone is and how Promises uses it to  alleviate withdrawal symptoms for people who are addicted to opiates.

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.”

Find relief in recovery. Life gets better with addiction treatment.

Call our experts today.