Suboxone is a medication containing buprenorphine combined with naloxone in a single tablet. It is used for medication-assisted treatment for addiction.
Buprenorphine has been successfully used to treat heroin addiction and it works by triggering the opiate receptors in your brain to reduce the intensity of cravings and withdrawal. Crucially, the medication achieves this without delivering the intense high or the dangerous side effects of other types of opioids.
Now, when buprenorphine is combined with naloxone, the abuse potential is further reduced. If you attempt to inject it, you’ll experience intense acute symptoms. When Suboxone is taken orally and as prescribed, though, you won’t suffer these adverse side effects.
A 2008 clinical trial examined the effects of a medication used to treat young adults with opioid addiction over an extended period. Data shows that patients who received counseling along with Suboxone during the 12-week trial had notably better outcomes than those who took the standard route of detoxification followed by counseling.
The youths addicted to opioids – morphine, heroin, and prescription painkillers – were more likely to abstain from using opioids, marijuana, and cocaine than the group who received counseling after short-term detox. They were also less likely to inject drugs than the control group and less likely to drop out the treatment program.
These findings are encouraging and also underscore the need for more long-term studies to establish whether sustained treatment of this nature conclusively improves patient outcomes.
Before we look at the side effects of long term use of suboxone, a little more detail about the medication itself.
What Is Suboxone?
Suboxone – a mixture of buprenorphine and naloxone – is a prescription medication used to treat dependence on opioids.
The brand-name version of this medication is an oral film you place under the tongue or between your cheek and gums. Whichever method you use, sublingual or buccal, this film dissolves in your mouth.
Each film contains 2 different drugs, buprenorphine and naloxone.
Suboxone is available in 4 strengths:
- 2mg buprenorphine & 0.5mg naloxone
- 4mg buprenorphine & 1mg naloxone
- 8mg buprenorphine & 2mg naloxone
- 12mg buprenorphine & 3mg naloxone
As mentioned above, there’s some research that indicates Suboxone can be effective for minimizing opioid abuse.
Suboxone is also shown in studies to help those with opioids dependence remain in treatment for long enough to kickstart recovery, potentially for 6 months.
The medication is a schedule III prescription drug. As a controlled substance, Suboxone has a legitimate medical use, but may also cause dependence (physical and psychological). Suboxone also has the potential for abuse.
A doctor is only permitted to prescribe Suboxone for opioid dependence once they’ve been specially trained and certified by the federal government.
Forms of Suboxone
Suboxone is available as a brand-name drug and also in generic form. The generic version is available in both film and tablet form.
How Is Suboxone Used?
The FDA approves prescription medications like Suboxone for the treatment of some conditions. Suboxone is also used off-label for other applications.
Suboxone comes FDA-approved for treating opioid dependence. The medication also comes as a treatment recommended by ASAM (American Society of Addiction Medicine). Suboxone helps with treating opioid dependence by minimizing the withdrawal symptoms that accompany quitting or reducing consumption.
Suboxone is occasionally used off-label for the management of opioid withdrawal symptoms. It’s used as part of a full detoxification program.
Detox programs are typically inpatient treatment plans used as a short-term method of weaning someone off opioids or alcohol.
Opioid dependence treatment, by contrast, is a much longer-term strategy. The majority of this treatment is conducted on an outpatient basis.
Suboxone can also be used for treating pain. This type of off-label use is controversial, though. It’s not yet clear how effectively, if at all, Suboxone can be for the treatment of pain. Results of studies are mixed.
How Does Suboxone Work?
As mentioned above, Suboxone has two ingredients: naloxone and buprenorphine. Each of these drugs has a distinct role.
What Naloxone Does
The only reason for naloxone’s inclusion in Suboxone is to reduce the chance of the medication being abused.
Naloxone is an opioid antagonist. As such, it blocks the positive effects of opioids.
When you’re dependent on opioids and you decide to inject Suboxone, the naloxone component could cause hazardous withdrawal symptoms. This can occur because the medication counters the effects of opioids and pushes you into instant withdrawal.
To minimize the likelihood of this happening, you could use the film form of Suboxone. This releases less naloxone than an injection, therefore instant withdrawal is less likely.
What Buprenorphine Does
Buprenorphine shares some effects with opioid drugs, but at the same time it blocks some of the effects of opioids, making it an opioid partial agonist-antagonist.
It’s buprenorphine that serves to treat dependence on opioid drugs by reducing cravings and withdrawal symptoms. Also, as an opioid partial agonist-antagonist, buprenorphine won’t cause a high like most opioids.
OK, now you’ve seen what Suboxone is and how it works, how does a typical course of treatment unfold?
Treatment Phases
There are 2 discrete phases to the treatment of opioid dependence:
- Induction
- Maintenance
Suboxone is normally used during both phases.
During induction, Suboxone can lessen withdrawal symptoms if opioid use is being either reduced or stopped. It will only be used during the induction phase for anyone addicted to short-acting opioids, including morphine, codeine, heroin, and oxycodone. It will only be used when the effects of the opioids have started to diminish and withdrawal symptoms begin.
When treatment shifts into the maintenance phase, Suboxone is used for an extended period once the dosage has stabilized. The goal of this phase is to ensure cravings and withdrawal symptoms are managed as you advance through your treatment program. This could last several months to over a year.
When you stop using Suboxone, your doctor will employ a slow dosage taper so you don’t experience any unpleasant side effects.
Now, more on those side effects so you can see what risks you run when using Suboxone.
Suboxone Side Effects
Suboxone can bring about both mild and serious side effects.
What follows is not a comprehensive list of side effects. That said, every user by no means experiences all of these adverse side effects either, much like the side effects of Adderall or any other medication.
Most Common Side Effects
Some of the most common Suboxone side effects include:
- Headache
- Body aches
- Rapid heart rate
- Abdominal cramps
- Anxiety
- Weakness
- Fatigue
- Sweating
- Insomnia
- Burning tongue
- Depression
- Constipation
- Back pain
- Nausea
- Redness in the mouth
Many of these issues will clear up in a matter of days or weeks. If they become more severe or linger, you should consult with your pharmacist or doctor.
Long-Term Side Effects of Suboxone
While it’s not common for patients to experience serious side effects from Suboxone, they can manifest.
Call your doctor immediately if you have severe side effects. If these symptoms seem life-threatening, call 911.
Serious side effects include the following:
- Abuse and dependence: Long-term use of Suboxone can cause both physical and psychological dependence. It can also create cravings for drugs and drug-seeking behavior, sometimes leaving to abuse. From here, overdose and death can occur. The risk of this is amplified if Suboxone is used with benzodiazepines, alcohol, or other opioids
- Breathing problems: Suboxone in high doses can cause breathing problems. In severe cases, this can lead to coma and death. This is more likely to occur if other drugs are used with Suboxone, and it’s more likely to happen if you have an existing breathing problem like COPD (chronic obstructive pulmonary disease)
- Severe allergic reaction: Allergic reactions like anaphylaxis can occur. Look for symptoms like skin rash or hives, difficulty breathing, or swelling of the throat, tongue, and lips. Call for immediate medical assistance or go to the nearest ER
- Liver damage: People using Suboxone have experienced both mild and severe liver damage. Expect blood tests to monitor liver function if you’re being treated for opioid dependence with Suboxone
- Adrenal insufficiency: Some people using Suboxone for a few weeks find themselves with reduced cortisol hormone levels, also known as adrenal insufficiency.
Severe Withdrawal Symptoms
The naloxone in Suboxone is included purely to help prevent the medication being abused. The ingredient means you could suffer severe withdrawal symptoms in the event of Suboxone abuse.
Naloxone acts as an opioid antagonist, meaning it blocks the effects of opioid drugs. If you find yourself opioid-dependent and you use Suboxone to shoot up, it will simply counter the effects of the opioids in your system, potentially triggering instantaneous withdrawal symptoms.
If you use the film version of Suboxone, you won’t experience these severe effects as you don’t get as much naloxone released into your system.
The film could, however, cause some symptoms of withdrawal if you take it with opioids still in your system. You should, then, only use Suboxone film once the effects of the opioids start wearing off and you start to feel the onset of withdrawal symptoms.
Are these withdrawal symptoms inevitable, though?
How To Avoid Withdrawal Symptoms
You should only use Suboxone with short-acting opioids. With long-acting opioids, the drug will cause heightened withdrawal symptoms. Short-acting opioids include morphine, codeine, heroin, and oxycodone.
Using Suboxone film will release less naloxone and minimize the chance of withdrawal symptoms.
How To Get Help with District Recovery
Are you concerned about your relationship with opioids? If so, it doesn’t matter whether you’re addicted to heroin or abusing prescription opioid painkillers, help is at hand with District Recovery and there’s no need to go it alone.
Take the first important step to recovery today and call our friendly team at 844.287.8506.
