Suboxone plays a vital role in the war against opioids, which has snuffed out lives and whole communities. When used as intended, Suboxone can counter the effects of highly addictive opioids like heroin and OxyContin.
Adam Bisaga, MD, told CNN this about Suboxone: “If [people with opioid addictions] take it properly, they have no cravings, they have no withdrawal, and they feel ‘normal…that’s why the medication is so effective.”
As with other prescription treatment medications, Suboxone can also be a substance of abuse. While there are people who champion Suboxone as a bulwark against the relentless opioid epidemic, it also has its fair share of critics.
A 2016 report from The New York Times says, “…law enforcement officials — and many former addicts and their families — are lining up on the other side, arguing that Suboxone only continues the cycle of dependence and has created a black market that fuels crime.”
For as many who believe Suboxone is a drug of abuse, some people view it as a salvation.
One Reddit poster wrote, “I overdosed six months ago, and the hospital put me in an in-patient treatment program. I came out of there with a Suboxone’ script, and my primary care doctor has kept me on a tapering dose ever since. Thanks to the Suboxone, I’ve managed to clean my life up a little bit. I’ve got a job that’s keeping me off the streets, and I’m saving money for a car.”
If you or a loved one is thinking about using Suboxone or you fear the prospect of addiction, read on to learn more about its benefits and dangers, and possible treatment options.
What Is Suboxone?
Suboxone is a combination drug comprised of buprenorphine and naloxone. The U.S. Food and Drug Administration (FDA) approved Suboxone, along with Subutex (buprenorphine alone), to treat opioid dependence.
Unlike methadone, the long-standing opioid treatment, Suboxone can be administered in a doctor’s office, making it readily accessible. It also does not have the potency of methadone, which also has a history of being abused.
The buprenorphine in Suboxone works like a regular opioid medication in that it binds to opioid receptors. The difference, however, is that buprenorphine partially binds to those receptors. This partial action results in Suboxone yielding a weaker, “ceiling effect” than full-on opioid drugs like heroin and methadone. The naloxone portion of the drug is an opioid blocker or antagonist, so it thwarts any effects from the original opioid.
Ideally, when people take Suboxone at recommended doses, they experience reduced opioid cravings, and withdrawal symptoms are addressed.
Suboxone is available as a tablet and film strip, which is either placed under the tongue (sublingual) or between the gums and cheek (buccal).
Recommended Suboxone Dose Amount
According to RxList, the recommended target dosage per day for the Suboxone tablet is 16/4 milligrams (mg) — that is, 16 mg of buprenorphine to 4 mg of naloxone.
For Suboxone film, it is recommended that users start at 8/2 mg (8 mg of buprenorphine to 2 mg of naloxone) on the first day of use. On the second day, film strip users can take a single daily dose of up to 16/4 mg.
For maintenance therapy, the recommended target dosage is also 16/4 mg, according to Suboxone drug makers Indivior.
Suboxone is habit-forming and capable of being a substance of abuse. Many people who have an addiction to opioids abuse it. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported a tenfold increase in emergency room visits involving Suboxone in a five-year period (from 2005 to 2010). That same report indicated that more than half of the 30,000 hospitalizations in 2010 were for the nonmedical use of buprenorphine — people taking Suboxone to get high.
According to RxList, use of this product can trigger dangerous side effects, such as:
- Trouble concentrating
- Feeling drunk
- Mouth pain
- Mouth redness
- Mouth numbness
- Stomach pain
- Tingling or numbness
It can also produce severe effects, some of which are life-threatening, like:
- Difficulty waking up
- Unusual drowsiness
- Slow or shallow breathing
- Fast or irregular heartbeat
- Severe dizziness
Death by Suboxone
Suboxone use has resulted in death. According to FDA data, severe respiratory depression and death have occurred with buprenorphine medications. Death can occur when users take buprenorphine medication intravenously with benzodiazepines and another central nervous system (CNS) depressant medication.
When Suboxone Addiction Is Present?
As with any drug addiction, a user will exhibit physical, mental, and behavioral signs. If you fear you or a loved one’s Suboxone use has gotten out of hand and addiction exists, here are some signs to look for, according to the Mayo Clinic:
- Needing more of the drug to experience the same effect (tolerance)
- Becoming overly dependent on the medication when taking too much of it becomes an issue
- Taking larger than recommended amounts in a single dose or for a longer-than-prescribed period
- Experiencing withdrawal symptoms when you stop taking Suboxone (dependence)
- Using Suboxone in the face of adverse consequences like health or legal problems (addiction)
- Experiencing intense urges for the drug that it blocks out any other thoughts
- Spending most of your time trying to get your hands on Suboxone, using it or recovering from its effects
- Doing things to get Suboxone that you would not normally do, such as stealing and
- Driving or engaging in other risky activities while under the influence of Suboxone
- Spending money on Suboxone although you cannot afford it
- Displaying poor performance at work or school
- Isolating from family and friends and not meeting obligations because of the drug
- Failing in your attempts to stop using the drug
- Making sure you have a supply of Suboxone that you can access
Is Suboxone Use Dangerous?
Because of the dangers associated with Suboxone, it is highly recommended that you seek professional addiction treatment.
A reputable program administered by certified addiction experts can provide the kind of careful, supervised process that allows you to safely and comfortably recover from addiction.
Professional treatment starts with medical detox, where the substance is gradually removed from your body, and withdrawal symptoms are treated with FDA-approved medications.
Residential treatment is ideal for severe cases because it allows clients to live at the facility while they receive therapy and care.
Opioid addiction, even to a treatment medication like Suboxone, is tough to battle. So treatment means addressing the mental and emotional aspects of substance abuse, not just the addiction itself.
Here are the evidence-based therapies available in residential treatment:
- Life skills training
- Behavioral therapy
- Motivational interviewing
- Group therapy
- Family therapy
For milder addictions, there is outpatient treatment, which offers therapy and counseling on a part-time basis.
Clients who are exiting out of a residential program and require more treatment can also enter outpatient.
The great thing about outpatient is that you can receive therapy and counseling while living independently. Because recovery does not end when treatment does, we can connect you to a relapse prevention program that provides ongoing support.