The abuse of opioid drugs reaches into the far corners of the world. An estimated 26.4 million to 36 million people abuse opioids globally, according to the National Institute on Drug Abuse (NIDA).
Here in the US, 467,000 people are addicted to heroin and 2.1 million people suffer from a substance abuse disorder related to opioid prescription opioid painkillers such as Vicodin, OxyContin, or Percocet, NIDA reports.
Opioid drugs are derived from the opium poppy plant and include both prescription medications and street drugs such as heroin. They function by blocking pain receptors in the brain and creating a relaxed and mellow state. These qualities make opioid narcotics ideal for use as pain relievers and relaxation tools in medical settings.
Opioid prescription drugs are very potent, however. Even when used as directed, they have the potential for creating tolerance and dependency when used regularly or for an extended period of time. When these drugs are abused, they can produce an intense rush of euphoria, or a high, that users are eager to reproduce again and again, thus increasing the chances of becoming addicted to opioids.
Oftentimes, a smoother recovery from opioid abuse or dependency can be attained by using medications during the detox phase of treatment. Suboxone is a buprenorphine product, also containing naloxone, used during opioid detox to help manage withdrawal symptoms and curb drug cravings, promoting a sustained recovery. Suboxone and Subutex, another buprenorphine product containing only buprenorphine, were the first narcotic drugs approved by the U.S. Food and Drug Administration (FDA) to be prescribed in a doctor’s office and picked up in a local pharmacy under the Drug Abuse Treatment Act (DATA) of 2000.
In the past, opioid dependency was commonly managed with methadone, a long-acting opioid dispensed in federally regulated clinics once a day. Suboxone is a viable alternative to methadone that comes in sublingual film strips that are dissolved under the tongue.
How Suboxone Works
Opioid abuse and dependency make changes to the chemical pathways of the brain, interfering with the brain’s natural production of neurotransmitters, or messengers, responsible for feelings of pleasure such as dopamine. Opioid drugs fill opioid receptors throughout the central nervous system, slowing down breathing, heart rate, blood pressure, and body temperature as well as blocking pain sensations.
Over time, the brain may become tolerant to the amount of opioid drugs you are taking, and you may have to raise your dose in order to feel the same effects as before. You may also develop a physical and psychological dependency to opioids, meaning that your brain now expects and relies on the drug’s interaction in your system in order to feel balanced.
When opioids are then removed, you may experience withdrawal symptoms that can be uncomfortable and have both emotional and physical side effects. Flu-like symptoms as well as restlessness, insomnia, irritability, agitation, depression and drug cravings may accompany opioid withdrawal. It is never recommended to stop taking opioids suddenly on your own, as it can precipitate opioid withdrawal syndrome. Instead, drugs like Suboxone may be used during medically assisted detox therapy.
Suboxone contains four parts buprenorphine, a partial opioid agonist, and one part of the largely dormant naloxone, which is an opioid antagonist. Partial opioid agonists fill the same receptor sites as the other full opioid agonists do, just not all of the way. This generally means that Suboxone does not create the same high as other opioids but does limit the negative withdrawal symptoms and cravings since there is still some measure of opioid drug in your system.
Buprenorphine has a longer half-life than many other opioid drugs as well, meaning that it will stay in your system longer and help keep things balanced and even. Buprenorphine also has a built-in ceiling effect, so that even if users take more than they should at one time, the drug will not have any more of the desired effects, thus lowering the potential for abuse. Naloxone is an opioid antagonist that remains dormant in Suboxone unless the drug is abused by injection. Opioid antagonists serve to reverse the effects of opioid agonists and induce withdrawal. The addition of naloxone to Suboxone is intended to further keep the drug from being abused.
Suboxone is still an opioid narcotic with the potential for abuse, and it is a Schedule III substance regulated by the Drug Enforcement Agency, or DEA.
Potential Side Effects of Suboxone
Medications such as Suboxone may be very useful during medically assisted detox treatment when used under direct supervision of health care professionals. Generally speaking, completing a treatment program in its entirety and remaining sober for at least a year are measures of success for drug rehab, and buprenorphine products may be successful in promoting recovery in these terms – in fact, as much as 40 to 60 percent of the time, as published by Psychology Today.
In 2012, over nine million prescriptions for Suboxone were dispensed according to the DEA. Suboxone is often preferred over the highly abused and more tightly regulated full opioid agonist methadone.
Suboxone is not without risk factors, however, and in order to avoid the potentially dangerous precipitated withdrawal syndrome, you need to be completely honest about when your last dose of opioid drugs was. Precipitated withdrawal is the rapid onset of difficult withdrawal symptoms that may occur if you start taking Suboxone before the last dose of the full opioid is out of your system completely. For example, heroin and most prescription opioids, with the exception of extended-release formats, are short-acting and likely leave your system in eight to 12 hours. Extended-release forms may take up to 24 hours to be removed from your bloodstream. Methadone is longer-acting, and you should wait at least 36 hours after your last dose of methadone before taking Suboxone.
You should also never mix Suboxone with other drugs or alcohol as this can increase all the risk factors of both substances and may have an unintended adverse effect.
In addition to precipitated withdrawal, Suboxone may have the following side effects:
- Nausea or vomiting
- Lowered blood pressure
- Depressed respiration
- Mouth numbness
- Back pain
- Blurred vision
- Irregular heart rate
Buprenorphine products like Suboxone have a low potential for abuse, and overdose on Suboxone alone is rarely life-threatening; however, it may still have addictive qualities. In 2011, approximately 21,483 emergency department (ED) visits and three deaths were reported to be related to the non-medical use of buprenorphine, according to the DEA. Suboxone can be an effective component of medically assisted detox treatment for opioid dependency when used correctly and as a part of a more comprehensive substance abuse treatment plan.
Detox is the purging of hazardous chemicals from the body and often the first step in a drug abuse or dependency treatment model. Medications like Suboxone can be very useful in achieving initial physical stabilization. Medical professionals may set you up on a schedule for Suboxone during detox that will slowly lower your dosage over a period of time until you no longer require it.
Addiction treatment should also address the emotional and psychological components of substance abuse and dependency through therapies and counseling. Addiction is a disease affecting both the motivation and reward centers in the brain, requiring you to essentially retrain your brain’s chemical pathways for a successful recovery. Behavioral therapies enhance your positive thoughts and behaviors and help you to develop new life skills that can aid you in coping with future stressors without resorting to self-destructive behavior patterns and actions. Group counseling sessions will help you to understand all of the factors related to addiction and how to make positive changes in your life and relationships.
Our highly trained staff members at Michael’s House strive to help patients achieve and maintain a healthy emotional, physical and spiritual balance, with comprehensive treatment models individually created to ensure a smooth and successful recovery. Call to speak with an admissions coordinator today for more information.
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