What is Suboxone?
Suboxone is a prescription medication used to treat opioid addiction. Alongside counseling and therapy, Suboxone treatment can be a useful tool and is shown to increase the chance of success. It is made up of both buprenorphine and naloxone with the purpose to curb withdrawal symptoms and minimize the effects of opioids. While most modern evidence-based facilities utilize suboxone medically assisted treatment, many remain resistant to this type of treatment. 12-step based centers are generally wary of this type of treatment as they believe Suboxone treatment is replacing one opioid with another. While Suboxone is, in fact, an opioid, there are some key differences. Suboxone is used as a prescription to opioid dependence because it helps ease cravings and has a low risk of abuse. How Suboxone works
The Buprenorphine Part
Suboxone is made up of two parts: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist with a long half-life. Why buprenorphine is attractive pharmacologically is due to its ceiling effect at higher doses; meaning that while it is an opiate, and it does block pain receptors and induce a mild euphoria, the effect is thought to plateau if taken larger doses. For this reason, the drug has a low potential for abuse, making it a good candidate for opioid withdrawal. Buprenorphine, being a partial agonist, also has a lower risk for overdose. Finally, because of its 35-hour half-life, buprenorphine can stay in the bloodstream 10-times longer than a regular opioid like oxycodone – meaning withdrawal symptoms will subside longer. While yes, buprenorphine is an opioid, it has a low potential for abuse, low risk of overdose, and can subside withdrawal symptoms for over a day.
The Naloxone Part
While buprenorphine is used to help individuals curb their withdrawal symptoms, naloxone is used to minimize the effects of opioids: both the buprenorphine itself and any other additional opioids ingested. Naloxone is an opioid antagonist and works by blocking the effects of opioids, both those from inside and outside the body; therefore the euphoric effects of the buprenorphine are negated by naloxone. Skeptics and critics of Suboxone MAT view it as replacing one opioid drug with another. While Suboxone is technically an opiate narcotic, there are some key differences between using an opioid like heroin or oxycontin and physician-prescribed Suboxone. The similarities of these drugs lie in the fact that people must continue to take the medication regularly (once a day for suboxone) or they will feel violently ill from the withdrawal effects. While this is a difficulty with the drug, suboxone does not contribute the same adverse side effects that come with heroin and other opioids such as the withdrawal from life and its obligations. Suboxone allows individuals to function normally each day without the need to use and removes them from the drug culture altogether
Effectiveness
Studies for Suboxone alone are scarce, but there are a variety of quality studies done for both buprenorphine and naloxone. A Swedish study on buprenorphine in 2003 determined that patients s of buprenorphine were 1.82 times more likely to stay in treatment and decreased the number of opioid-positive drug tests by 14.2 percent. Regarding naloxone, there was a study in Russia that demonstrated its effectiveness. The NIH stated that naloxone had 90% confirmed abstinent weeks compared to 35% without the naloxone medication. Treatment retention was also higher and a decrease in relapse.
Medically Assisted Treatment
Medically Assisted Treatment is considered the gold standard for opioid treatment. Various studies, including systematic reviews of the research, have found that medication-assisted treatment can cut the all-cause mortality rate among addiction patients by half or more. This decrease in mortality rate is in part due to the fact that MAT increases a person’s likelihood of remaining in treatment, which itself associates with lower risk of overdose mortality, reduced risk of HIV and HCV transmission, reduced criminal justice involvement, and a greater likelihood of employment.
Employment is one of the aspects we try to actively implement here at Coalition Recovery because we understand its importance. Obtaining employment can be the boost needed to help an individual gain independence and purpose – two major forces in determining long-term recovery success. Therefore, we implement everything in our program that will increase the likelihood of sustained employment. Click Here to Learn How We Do This
Suboxone will continue to receive criticism for being an opioid, but the truth is, it is helping people live healthy lives again. Suboxone allows people to live free from the everyday struggles of feeding an addiction: financial damage, dangers of buying, and overall destruction that comes with a severe addiction: physical, mental, and social. Suboxone is not a “magic pill” cure but rather a tool. You can give someone a power drill, but that doesn’t necessarily mean they can build you a chair. Because of this “miracle drug” misconception, many people are upset when they relapse: ultimately concluding that the MAT does not work for them. Suboxone is supposed to be a part of the treatment plan alongside building a support system,12-step meetings, practicing self-care, and nurturing an aspect of your life that gives you purpose. After all, it is Medically ASSISTED Treatment. Alongside counseling and therapy, Suboxone MAT can and does give a person better chances for success. If this tool makes a problematic situation more manageable, why shouldn’t it be readily available for anyone who wants it?
Side Effects
The keyword here is “want.” MAT will not work, and in some cases can cause significant harm, if forced on the individual. A person does not want to receive MAT, is not ready to fully commit to his/her sobriety and is likely to use again. With Suboxone this can be dangerous; naloxone blocks opioid receptors meaning a person can drink or use an opioid without feeling the desired euphoric effects causing a high potential for overdose considering a person might try to use more and more to feel their desired effects. MAT should not be the first course of action for an individual just beginning treatment for the first time. A sober free life without the reliance towards a once-a-day medication is the ideal scenario; which is why MAT might be something left for individuals who have had a hard time finding recovery and need extra assistance. Treatment centers must first attempt to help people gain sobriety through conventional means such as counseling, education, talk therapy, and other holistic approaches. Hopefully, the individual can use these methods to help them in recovery throughout their life. The ideal goal of treatment is to be 100 percent self-reliant without the need for medication, but that is rarely the outcome. Much like the millions of people reliant on medication for depression and anxiety, people should be prescribed Suboxone because all other measures have failed. The freedom medication gives someone far outweighs the burden of daily administration. Suboxone may not be the ideal scenario for treatment, but for the right candidates, it can be hope during a time when all else fails. Much of the criticism of Suboxone and MAT stems from stigma. Saying Suboxone is replacing one opioid with another is an oversimplification just as a smallpox vaccine is not simply giving you the virus – there’s a greater outcome here. Finding long-term recovery is not an easy task and can take years to reach, but if you look at the bigger picture, this type of MAT is giving people a better possibility towards true recovery. Suboxone MAT can be extremely beneficial when implemented correctly; therefore, this type of treatment should not be ruled out.
