Table of Contents

Suboxone: Effective Treatment for Opioid Withdrawal & Addiction

suboxone

Clinically Reviewed by: Dr. Robin Campbell, LMFT, PHD

What is Suboxone?

In the battle against opioid dependency, a complex and often misunderstood condition, one medication has emerged as a cornerstone in the comprehensive approach to substance abuse treatment: Suboxone. This combination drug product, consisting of buprenorphine and naloxone, targets the harsh reality of opioid withdrawal symptoms with a unique pharmacological profile. As a partial opioid agonist, buprenorphine offers relief from withdrawal while minimizing the opioid effects that can lead to further abuse. Buprenorphine occupies a midpoint between opioid full agonists and opioid antagonists, providing a blockade to subsequently administered opioid agonists, making it appealing for patients with opioid dependency. Meanwhile, naloxone, an opioid antagonist, serves as a safety measure, triggering acute withdrawal symptoms if the medication is misused by injection. Designed specifically for sublingual administration, Suboxone sublingual film is a key player in both the induction phase of treatment for opioid overdose recovery and the long-term maintenance treatment. The dual action of buprenorphine and naloxone addresses not only the physical dependency but also aids those grappling with co-occurring mental health disorders, enhancing overall safety and efficacy.

What is Suboxone?

Suboxone is a medication commonly used in the treatment of opioid addiction. It contains two main ingredients: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, which means it activates the opioid receptors in the brain but to a lesser extent than full agonists like heroin or morphine. This activation helps to reduce cravings and withdrawal symptoms in individuals addicted to opioids.

Naloxone, the other component, is an opioid antagonist that helps to prevent misuse of the medication. When taken as prescribed, naloxone has minimal effects because it is poorly absorbed sublingually (under the tongue). However, if the medication is injected, naloxone will block the effects of buprenorphine and other opioids, precipitating withdrawal symptoms and discouraging misuse.

Suboxone is typically prescribed as part of a comprehensive treatment plan that includes counseling and behavioral therapies to help people overcome opioid addiction.

 

Suboxone Types and Dosages

Suboxone is available primarily in the form of sublingual films and tablets, which are to be placed under the tongue or between the gums and cheek where they dissolve. Here are the common dosages:

  1. Sublingual Films: These come in several strengths, typically measured in milligrams of buprenorphine/naloxone. Common dosages are 2 mg/0.5 mg, 4 mg/1 mg, 8 mg/2 mg, and 12 mg/3 mg.

  2. Sublingual Tablets: Similar to the films, these are available in dosages like 2 mg/0.5 mg, 8 mg/2 mg, etc.

The appropriate dose of Suboxone varies based on the individual’s needs, the severity of opioid dependence, and previous response to treatment. Treatment usually starts with a single daily dose and can be adjusted under the supervision of a healthcare provider.

 

Suboxone Uses 

Suboxone is primarily used for two main purposes in the treatment of opioid dependence:

  1. Detoxification: Suboxone helps manage withdrawal symptoms during the initial phase of opioid detoxification, making it easier for individuals to stop using opioids.

  2. Maintenance Therapy: After detoxification, Suboxone can be used as a long-term maintenance medication. It helps reduce cravings and the likelihood of relapse by partially activating opioid receptors without producing the high associated with opioid abuse.

In addition to these uses, Suboxone can contribute to a holistic treatment plan that includes counseling and behavioral therapies, helping individuals to rebuild their lives and manage their addiction effectively.

 

How Long Does Suboxone Stay in Your System?

Suboxone’s duration in the body depends on several factors, including the half-lives of its active ingredients, buprenorphine and naloxone.

  1. Buprenorphine: Buprenorphine has a long half-life, typically ranging from 24 to 42 hours, but it can be longer in some individuals. This means it can stay in the body for several days, generally estimated to be up to five to eight days before it’s fully eliminated.

  2. Naloxone: Naloxone has a much shorter half-life, generally around 2 to 3 hours. It tends to be cleared from the body much more quickly, usually within 24 hours.

Due to buprenorphine’s long half-life, Suboxone is often dosed once daily. Its lingering presence in the body helps to maintain stable blood levels, which aids in managing withdrawal symptoms and reducing cravings effectively.

 

How Long is Suboxone Detectable in Your System?

Suboxone’s detectability in the body depends on several factors, including the specific drug test used and individual metabolic differences. Here’s a general guideline for how long Suboxone can be detected in various tests:

  1. Urine Tests: Suboxone can typically be detected in urine for 7 to 10 days after the last dose. However, this can vary based on dosage and individual metabolism.

  2. Blood Tests: Buprenorphine, the active ingredient in Suboxone, can be detected in blood for up to 2 days after the last use.

  3. Saliva Tests: Suboxone can be detected in saliva for up to 3 days after the last use.

  4. Hair Tests: Hair testing can detect drugs for a longer period, up to 90 days or more after the last dose, reflecting use over a prolonged period.

 

How Does Suboxone Work in the Brain and Body?

Suboxone works by targeting opioid receptors in the brain. Its active ingredient, buprenorphine, is a partial opioid agonist that binds to these receptors, reducing cravings and withdrawal symptoms without producing a significant high. This action also blocks other opioids from binding to the receptors, preventing their effects. The second ingredient, naloxone, is an opioid antagonist that counteracts opioid effects if the medication is misused by injection, promoting safe usage. Together, these actions help manage opioid dependence effectively.

 

Suboxone Effects on the Body

Suboxone has various effects on the body, primarily aimed at managing opioid addiction:

  1. Reduces Cravings and Withdrawal Symptoms: By partially activating opioid receptors, Suboxone helps reduce the cravings and withdrawal symptoms associated with opioid dependence.

  2. Blocks Opioid Effects: Buprenorphine’s strong binding affinity prevents other opioids from activating these receptors, thus blocking their effects and reducing the risk of relapse.

  3. Safety Mechanism: Naloxone in Suboxone acts as a deterrent for misuse. If injected, it can precipitate withdrawal symptoms, discouraging this route of administration.

  4. Side Effects: Common side effects include nausea, headache, sweating, insomnia, and constipation. It can also cause more serious effects like respiratory depression if not used as prescribed.

 

Suboxone Efficacy

Suboxone is highly effective in the treatment of opioid addiction. It reduces opioid cravings and withdrawal symptoms, which can help individuals maintain abstinence from illicit opioids. Additionally, because it blocks the effects of other opioids, it is effective in preventing relapse. Clinical studies have shown that Suboxone, combined with counseling and behavioral therapies, significantly improves outcomes for individuals with opioid use disorder compared to treatments that do not include medication. Its efficacy is particularly noted in increasing treatment retention rates and reducing illicit opioid use.

 

Suboxone Side Effects 

Suboxone can cause a range of short-term and long-term side effects:

Short-Term Side Effects:

  • Nausea and vomiting

  • Headache

  • Sweating

  • Constipation

  • Insomnia

  • Dizziness

  • Respiratory depression (in cases of overdose or misuse)

Long-Term Side Effects:

  • Dependency on Suboxone itself, requiring careful tapering to discontinue use

  • Liver damage, including hepatitis and liver failure, especially in individuals with pre-existing liver conditions

  • Hormonal imbalances, such as reduced cortisol or sex hormone levels

  • Dental issues due to dry mouth

Both sets of effects can vary based on individual factors such as dosage, duration of use, and overall health.

 

Is Suboxone Addictive? 

Yes, Suboxone can be addictive due to its opioid component, buprenorphine. While it is a partial agonist with a lower potential for abuse compared to full opioid agonists like heroin or morphine, it still can cause physical dependence. The risk of addiction is generally lower when Suboxone is used as prescribed under medical supervision, as part of a comprehensive treatment plan for opioid dependence.

 

Can You Overdose on Suboxone?

Yes, it is possible to overdose on Suboxone, especially if it is taken in combination with other depressants like alcohol or benzodiazepines, or if used in a manner not prescribed by a healthcare provider. An overdose of Suboxone can lead to severe respiratory depression, which can be life-threatening. However, the risk of overdose is generally lower with Suboxone compared to full opioid agonists because of the ceiling effect of buprenorphine, which limits its ability to fully activate opioid receptors.

 

Alcohol Use and Suboxone

Mixing alcohol with Suboxone is strongly discouraged as it can lead to dangerous interactions. Alcohol and Suboxone both depress the central nervous system, which can significantly increase the risk of respiratory depression, sedation, and overdose. Additionally, combining these substances can enhance the side effects of each, leading to greater impairment and health risks. It’s important for individuals taking Suboxone to avoid alcohol to maintain safety and the effectiveness of their treatment plan.

 

Suboxone and Pregnancy

Using Suboxone during pregnancy is generally considered when the benefits outweigh the risks. It’s used to manage opioid dependence, which if untreated, can have more severe outcomes for both the mother and the fetus. Suboxone can reduce the likelihood of relapse and promote a more stable prenatal environment.

However, like other opioids, Suboxone can lead to neonatal abstinence syndrome (NAS), where the newborn experiences withdrawal symptoms after birth. Pregnant women on Suboxone should be closely monitored by healthcare professionals, and the treatment should ideally be coordinated within a comprehensive maternal-fetal medicine program to manage both the mother’s dependency and the infant’s health post-birth.

 

Suboxone Storage and Disposal

Storage: Suboxone should be stored at room temperature, away from light and moisture, in its original packaging until use. Keep it out of reach of children and pets to prevent accidental ingestion.

Disposal: Suboxone should be disposed of properly to avoid misuse or accidental exposure. Do not flush the medication down the toilet unless specifically instructed to do so. Check if your community has a drug take-back program, or ask your pharmacist about secure drug disposal boxes. If these options are not available, you can mix Suboxone with an undesirable substance (like used coffee grounds or kitty litter) in a sealable bag before throwing it in the trash to make it less appealing for accidental or intentional misuse.

 

Suboxone Interaction with Other Medications

Suboxone can interact with various medications, potentially causing harmful effects:

  1. CNS Depressants: Combining Suboxone with central nervous system depressants like benzodiazepines, alcohol, or sedatives can significantly increase the risk of respiratory depression, sedation, and death.

  2. Serotonergic Drugs: When used with medications that affect serotonin levels, such as certain antidepressants and migraine medications, Suboxone can increase the risk of serotonin syndrome, a potentially life-threatening condition.

  3. CYP3A4 Inhibitors: Drugs that inhibit CYP3A4 (an enzyme that metabolizes buprenorphine) can increase the levels of Suboxone in the blood, enhancing its effects and side effects.

 

Suboxone Controlled Substance Classification

Suboxone is classified as a Schedule III controlled substance in the United States. This classification indicates that while Suboxone has a legitimate medical use, it also has a potential for abuse that is less than Schedule I and II substances but greater than those in Schedule IV. As a Schedule III drug, Suboxone requires a prescription, and its distribution is regulated to prevent misuse and diversion.

 

Treatment Options

For opioid addiction, there are several effective treatment options that can be tailored to an individual’s needs. These include:

  1. Medication-Assisted Treatment (MAT): This combines medications such as Suboxone (buprenorphine/naloxone), methadone, or naltrexone with counseling and behavioral therapies. MAT is highly effective in reducing opioid cravings and withdrawal symptoms, helping maintain sobriety.

  2. Counseling and Behavioral Therapies: These can include cognitive-behavioral therapy (CBT), motivational interviewing, and group therapy sessions, which help address the psychological aspects of addiction.

  3. Detoxification Programs: Medically supervised detox helps manage withdrawal symptoms safely as the body clears itself of opioids.

  4. Residential Treatment Programs: These provide a structured environment with constant support, making it easier to focus on recovery without the distractions or triggers of daily life.

  5. Support Groups: Groups like Narcotics Anonymous (NA) offer peer support and encouragement, which can be crucial for long-term recovery.

Each treatment plan should be individualized, taking into account the person’s specific needs, the severity of addiction, and any co-occurring mental health conditions.

 

Does Insurance Cover Suboxone Addiction Treatment?

Yes, many insurance plans, including Medicaid and Medicare, often cover Suboxone treatment for opioid addiction as part of medication-assisted therapy (MAT). Coverage can vary by provider and plan specifics, such as deductibles and co-payments. The Affordable Care Act requires most insurers to cover substance use disorder treatments, but it’s important for individuals to check directly with their insurance provider to understand the specifics of their coverage, including any pre-authorization requirements or limitations on duration of use.

 

Conclusion

As we delve into the dynamics of treating opioid addiction, Suboxone stands out for its role in moderating not just the physical but also the psychological facets of dependency. Its capacity to manage symptoms with a steady dose while blocking the effects of other drugs, including short-acting opioids and illegal drugs, underpins its significance in opioid medication protocols. However, while Suboxone offers a pathway out of the cycle of drug abuse, it’s crucial for patients and healthcare providers to navigate its use carefully, considering potential adverse effects and the risk of physical dependency. With the right oversight, including guidance on not to drink alcohol during treatment, and support from health insurance, Suboxone can be an effective part of a broader treatment plan. This includes addressing liver-related health issues, ensuring it is habit-forming only under controlled circumstances, and offering hope to buprenorphine patients striving for a healthier, substance-free life.

 

Seeking Treatment? We Can Help!

At New Hope Healthcare, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being. Give us a call at 866-799-0806

suboxone

Frequently Asked Questions

Suboxone is primarily used to treat opioid addiction. It helps reduce cravings and withdrawal symptoms, making it easier to maintain abstinence from opioid use.
Suboxone contains buprenorphine, a partial opioid agonist, and naloxone, an opioid antagonist. Buprenorphine reduces withdrawal symptoms by mildly stimulating opioid receptors, while naloxone prevents misuse of the medication by causing withdrawal symptoms if the drug is injected.
Suboxone can be addictive because it contains buprenorphine, an opioid. However, it is considered safer and has a lower risk of addiction than full opioid agonists. It is used under medical supervision to manage opioid dependence.
It is possible to overdose on Suboxone, particularly when it is combined with other depressants like alcohol or benzodiazepines. Symptoms of overdose include respiratory depression, extreme drowsiness, and loss of consciousness.
Most insurance plans, including Medicaid and Medicare, cover Suboxone treatment as part of medication-assisted therapy for opioid addiction. Coverage details can vary, so it’s important to check with your insurance provider for specifics regarding deductibles, copayments, and any limitations on coverage.

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