5 Things About Suboxone that are Misunderstood

What is Suboxone and how does it work?

Suboxone, is a “combination” medication containing two medicines: buprenorphine and naloxone. Suboxone is considered the primary medication in treating opioid addiction. Suboxone has been shown to lower fatal overdoses by approximately 50%. Suboxone also reduces the risk of nonfatal overdoses dramatically, which are both traumatic and medically dangerous.

Suboxone works by binding to the opioid receptors in the brain, just like other opiates do, such as heroin, morphine, OxyContin and oxycodone. By doing so it reduces intoxication from these other drugs. Suboxone also prevents cravings and virtually eliminates withdrawals, allowing many people to transition from a life of addiction to a regular life.

The vast majority of physicians and addiction experts agree: Suboxone saves lives.

Suboxone is much more widely available as of lately, allowing people who are addicted to opiates to more readily access it. Good places to start are in the emergency department and in the primary care doctor’s office. More doctors need to become “waivered” to prescribe this medication, which requires some training and a special license.

Suboxone has both a stigma attached to it due to the misinformation and lack of education provided to the public until just the last few years. Like any other disease, misinformation and/or confusion means more barriers to those who really need it – People who are addicted to opiates.

Falsehood #1: You’re Trading One Pill for Another

While it depends on how you define recovery, the 1930’s era was influenced by Alcoholics Anonymous abstinence-based models that have dominated the past 100 years of addiction care. These are now giving way to a more modern conception of what recovery is. The use of medications like Suboxone help regulate brain chemistry, and as addiction is increasingly viewed as a medical condition and also a disease, Suboxone is now being viewed as a treatment for a chronic condition. Just like a person with type 1 diabetes needs to take insulin, so might an opioid-addicted person need to take Suboxone. You are definitely in recovery and considered “clean” while taking Suboxone since the absence of euphoria makes Suboxone a tool for changing and restoring brain chemistry vs. as a replacement for getting “high”.

Falsehood #2: People frequently misuse Suboxone

While Suboxone is technically an opiate and could be misused, it is unlikely.Suboxone is only a “partial agonist” of the main opiate receptor. It causes far less euphoria than other opiates such as heroin and oxycodone. In many cases, Suboxone is used to manage withdrawals or to assist in getting off heroin or fentanyl. As Suboxone becomes more readily available, it reduces the need to “self treat’ these symptoms.

Falsehood #3: It’s Easy to Overdose on Suboxone (Similar to other opiates)

It is extremely difficult to overdose on Suboxone without using other medications and/or drugs along with it. It is much more difficult to overdose on Suboxone compared to other opiates because Suboxone is a “partial” opiate receptor agonist, so there is a built-in “ceiling” effect that prevents its efficacy. The ceiling creates a limit to how much the opioid receptors can be activated by Suboxone, so there isn’t as great a risk of slowed breathing as compared with potent opiates such as heroin, oxycodone, morphine or fentanyl. When people overdose on Suboxone it’s actually as a result of combining with sedatives such as benzodiazepines (ie: valium, klonopin) that also slow breathing.

Falsehood #4: Suboxone isn’t treatment for addiction if you aren’t getting therapy along with it

Ideally, addiction treatment should include therapy, recovery coaching, support groups, housing assistance, and employment support. But that doesn’t mean that Suboxone alone doesn’t constitute valid addiction treatment. While combination treatment is always the goal, it is not always possible due to varying circumstances for everyone in recovery to get all of the treatments they need, especially considering that a large percentage of the addicted population lacks proper healthcare and/or health insurance. Suboxone alone has been proven to be effective. However, it is considered far more effective when used in combination with other treatments such as private therapy, group therapy, EMDR, recovery coaching and other types of treatment.

Falsehood #5: Suboxone should only be taken for a short period of time

Even expert practitioners have different theories on how long Suboxone treatment should last, but there is no evidence to support the claim that Suboxone should be taken for a short period of time as opposed to being used as maintenance for long periods of time, or even life. Similar to a person with type 1 diabetes, a person may need to manage their addiction for the rest of their life. This really boils down to user preference – Can they maintain sobriety without Suboxone, or not?

What are your thoughts about Suboxone? We’d like to hear from you using the comments area below.