Suboxone

What Is Suboxone?

Here at HealthFaire we do not generally discus drugs or medications, we make an acceptation with Suboxone. This medication can change the life of anyone addicted or physically dependent on narcotics. How the medication is used will dictate if the change is for the better or a continued life of addiction and misery.

 
 
The U.S. Food and Drug Administration (FDA) approved the sale and use of Suboxone in 2002 for the treatment of opioid (natural, synthetic, semisynthetic) addiction.

Suboxone, made from buprenorphine and naloxone, is effective in the prevention of relapse in cases of opioid dependence.

  • Buprenorphine alleviates opioid cravings without offering  the intense high that comes with opioids and more powerful opioid derivatives.
  • Naloxone prevents the effects of opioids by blocking them at the opioid receptor, thus minimizing the possibility of misuse and reducing the risk of overdose.

The buprenorphine in Suboxone is a partial opioids agonist, which binds itself to the same receptors in the brain as opioids. The main function of Buprenorphine is to decrease opioid cravings and suppress withdrawal symptoms. If you’re addicted to opioids, visit a Suboxone clinic to seek help from medical professionals specializing in the treatment of opioid addiction.

Why Use Suboxone?

The medication Suboxone is prescribed to patients recovering from opioid addiction. Buprenorphine is used for induction therapy for drug addiction, methadone addiction, heroin addiction, and maintenance therapy for addiction.

How Long Does Suboxone Block Opioids?

Suboxone will block opioids for up to twenty-four hours. Most medical professionals instruct patients to take the medication one time each day at the same time. However, factors like weight, metabolism, and history of drug use can either increase or decrease the duration Suboxone offers protection from opioids. Your medical professional will look at all these factors, especially your medical history, and prescribe a customized Buprenorphine dosage.

How Long Does Suboxone Stay in Your System?

Suboxone may remain in your system for up to seventy-four hours. The Suboxone half-life for buprenorphine is thirty-seven hours after the dosage has been administered and the time it takes an individual to digest half the dosage. However, it takes Suboxone several days to exit your system completely. Withdrawal symptoms will occur within a few days after stopping the medication.

Suboxone and Pregnancy—What Are the Dangers and Should Suboxone Be Taken During Pregnancy?

Strict guidelines exist in the use of Suboxone during pregnancy. Women should discuss with their physician the following risks, among others, associated with a Suboxone treatment plan:

  • Since Buprenorphine is a type of opioid, the fetus may develop an addiction and newborns may experience withdrawal symptoms.
  • Possible birth defects associated with Suboxone:
    • Congenital Heart Defects – The heart does not fully form causing the child to develop heart problems in the future.
    • Gastroschisis – A hole develops in the abdominal wall of the newborn’s intestines causing the intestines to protrude.
    • Glaucoma – Pressure in the eyeball which can lead to blindness.
    • Hydrocephaly – The buildup of excess spinal fluid in the brain resulting in newborns with enlarged heads and pressure on the brain.
    • Spina Bifida – The spinal cord of the fetus fails to develop properly leading to physical and cognitive disabilities.

Careful consideration is given to women using Suboxone during pregnancy, but Suboxone is still considered a beneficial treatment option for pregnant women. If Buprenorphine is prescribed during pregnancy, a medical team will monitor the health of both the mother and baby throughout the pregnancy. Frequent medical visits will be required to monitor the development of the baby. Expectant mothers will also be referred for therapy, where they will be counseled on ways to live without opioid abuse. Regular follow-up care will be required, along with relapse prevention after the birth of the child.

Suboxone vs. Methadone: Which is Better?

Both Buprenorphine and methadone are used to treat opioid addiction. Methadone has been around since the 1960s whereas Suboxone is relatively new in the treatment of opioid addiction.

Methadone stimulates certain parts of the brain affected by opioid addiction. It is commonly administered once every twenty-four to thirty-six hours. Methadone will reduce withdrawal symptoms and drug cravings. Even though both types of medications are effective in treating opioid addictions, Suboxone may fare a little better than methadone, as you can use it outside of a clinical setting whereas methadone requires clinic visits on a more regular basis.

What Are the Pros and Cons of Suboxone vs. Subutex?

Pros

  • Suboxone is both a sublingual tablet and film whereas Subutex is a sublingual pill only.
  • Suboxone is 80 percent buprenorphine and 20 percent naloxone whereas Subutex contains 100 percent buprenorphine as the active ingredient.
  • The risk of patients abusing Subutex is much higher than the risk of patients abusing Suboxone.
  • You can take Suboxone at home as an outpatient treatment program whereas Subutex is not easily accessible for outpatient treatment programs. Unlike Suboxone, Subutex does not contain naloxone, which is an abuse deterrent.

Cons

  • The prescribed dosage of both Subutex and Suboxone is 8mg to 32mg each day.
  • The cost to buy Subutex is around $250 to $400 each month whereas Suboxone costs around $350 to $600 each month.
  • Both Subutex and Suboxone come with side effects.

Since the risk of abusing Suboxone is low, Suboxone is a better treatment option, but only a doctor can better guide you in determining which medication is best for you in eliminating cravings and withdrawal symptoms.

Is Suboxone Prescribed for Pain?

Suboxone is considered a beneficial option in the long-term treatment of chronic pain. Suboxone blocks receptors in your brain which convey pain messages. One advantage of taking Suboxone for pain management is that the risk of addiction is far less than with drugs like Vicodin. A major disadvantage, however, is that Suboxone is not yet cleared for pain management. Currently in the U.S., obtaining a pain-related prescription for Suboxone would require an off-label prescription, meaning the FDA does not recognize Suboxone as a pain medication. Certain derivatives of Suboxone such as Temgesic, Buprenex, Norspan and Butrans are used for pain treatment.

Is Suboxone Detectable on a Drug Test?

A drug screening test specially designed to look for traces of buprenorphine will detect the presence of Suboxone in the your system. However, an employer designing the drug screening test to specifically look for the presence of buprenorphine in the your system is less likely.

Most drug screening tests do not look for Buprenorphine, but will it show up in a urine test? No. this medication will not show up in a urine test, as it is less likely to detect its presence in the individual’s system. Urine tests usually identify traces of methadone, heroin, and other opioids, but not Suboxone. The substances most employers test for include:

  • barbiturates such as secobarbital and phenobarbital;
  • benzodiazepines such as Valium and Xanax;
  • cocaine;
  • marijuana;
  • MDMA such as Molly and Ecstasy;
  • methamphetamines and amphetamines;
  • opioids such as hydrocodone and oxycodone;
  • phencyclidine (PCP).

Even though Suboxone may not be the focus of employers’ drug screening tests presently, it may be in the future. Since 2011, many employers have begun to include Suboxone as part of their regular and random drug screening tests. For these tests to detect the presence of Buprenorphine in your system, high doses of the drug must be present for seven to ten weeks after last taking the medication. However, this varies from person to person, as everyone’s metabolism is different. To ensure the drug screening tests will not pick up the presence of Suboxone in the system, individuals may test themselves at different intervals to determine how long the medication remains detectable in their system. NOTE: Suboxone Clinics do test for Buprenorphine in the urine with a specialized test.

What Different Forms of Suboxone Are Available?

There are three different forms of Suboxone available on the market—strips and tablets.

Suboxone Strips

Suboxone strips are sublingual films that go under the tongue. The strips will completely dissolve in the mouth in one minute or less. Some physicians may prescribe two or more strips be placed under the tongue.

How to Administer Suboxone Strips

Patients instructed to use two strips need to place the first one close to the base on either the left or right side of the tongue and place the second on the opposite side to prevent overlapping. In rare cases, physicans may prescribe an increased dosage of three strips. In that case, place the third Suboxone strip under the tongue once the first two strips dissolve.

What is a Suboxone Strips High?

A Suboxone strips high refers to patients abusing the strips to get a high. It is very possible for users to get high on the medication strips. If you place more than one strip under your tongue, you may experience a euphoria. Some patients battling a Suboxone addiction may even dissolve the strips in water and inject the liquid (do not do this).

Precautions to Follow When Using Suboxone Strips

If you are perscribed Suboxone film or strips as part of your treatment plan for opioid addiction, you should first drink water to moisten your mouth before placing the strip under the tongue. Once the strip completely dissolves, only then should another strip be placed under the tongue if instructed to do so by a physician. Suboxone film or strips should not be chewed, cut, swallowed, or moved after placing it under the tongue.

Suboxone Tablets

Suboxone tablets contain 8mg of buprenorphine and 2mg of naloxone. You may take either a white or orange Suboxone pill. There is no difference in the formula or effect produced by the white or orange Suboxone pills. Suboxone pills are available from a traditional pharmacy or an online pharmacy.

How to Take Suboxone Tablets

Suboxone tablets should not be cut, crushed, chewed, or swallowed, but rather placed under the tongue until it completely dissolves. If instructed by your physician to take two tablets, do not place them in the same location under the tongue. Place the tablets beneath the tongue on opposite sides at the same time, or as directed by your physician.

If your physician has instructed you to take more than two Suboxone tablets, place two tablets at a time if placing several at one time causes discomfort. Do not drink or eat anything until the Suboxone pills have fully dissolved.

Suboxone Dosage for Both Strips and Tablets

The Suboxone dosage for strips and tablets is different for adults, the elderly, and adolescents.

  • Adults
    • Take 24mg/6mg of Suboxone film each day
    • Take 24mg/6mg of Suboxone tablets each day
  • Elderly
    • Take 24mg/6mg of Suboxone film each day
    • Take 24mg/6mg of Suboxone tablets each day
  • Adolescents
    • Take 24mg/6mg of Suboxone film each day
    • Take 24mg/6mg of Suboxone tablets each day

*Note: This is the maximum dosage for film and tablets and can differ from patient to patient depending on medical history and degree of drug addiction. You should only take the prescribed dosage as instructed by your physician.

Generic Suboxone

Yes, generic Suboxone is available. Some generic versions offer some of the same benefits as the brand version, but are more affordable. It has been available on the market since 2012. Generic Suboxone is available under the following names, although some are prescribed for pain treatment:

  • Suboxone Film
  • Bunavail
  • Buprenex
  • Butrans
  • Cizdol
  • Norspan
  • Probuphine
  • Temgesic
  • Zubsolv

*Note: You should not drink alcohol with any of these medications, as it can lead to dangerous side effects. Do not operate machinery or vehicles until side effects are fully known as Suboxone can cause dizziness, which can lead to accidents, falls, and other injuries.

What Are the Side Effects of Suboxone: Short-term, Long-term, Common and Serious?

Suboxone acts as a depressant, which functions to slow down the speed of the individual. Patients need to understand the short-term, common, and serious side effects involved with taking this medication.

Short-term Side Effects of Suboxone

Short-term side effects of Suboxone include:

  • a pain relieving effect that is twenty to thirty times more effective than morphine;
  • a mild euphoric effect that can last for about eight hours with other general effects lasting for 24 to 72 hours;
  • creates a sense of calm and false security;
  • creates a perception of decreased stress and worry;
  • causes the mind and body to become more relaxed.

Long-term Side Effects of Suboxone

Long-term side effects include:

  • drowsiness;
  • gastrointestinal problems (nausea, vomiting, and constipation);
  • confusion and disorientation;
  • decreased tolerance for pain;
  • psychological effects such as anxiety, isolation, increased likelihood of depression, and difficulty in adjusting in social situations;
  • extended issues such as failing relationships, unable to assume basic responsibilities such as parenting, school and work, financial strain, and legal issues related to addictive behaviors.

Common Side Effects of Suboxone

Common side effects of Suboxone include:

  • back pain;
  • blurred vision;
  • constipation;
  • decreased attention span;
  • dizziness;
  • drug withdrawal syndrome;
  • fainting;
  • headaches;
  • insomnia;
  • irregular heart beat;
  • lightheadedness or feeling as if intoxicated;
  • nausea and/or vomiting;
  • numb mouth;
  • painful tongue;
  • sleepiness;
  • sweating;
  • increased redness on the inside of the mouth.

Serious Side Effects of Suboxone

Serious side effects of suboxone include:

  • forming dependence;
  • forming an addiction;
  • slowed breathing;
  • feeling disoriented, faint, or dizzy;
  • issues with coordination such as being clumsy;
  • developing an allergic reaction such as rash, hives, swelling of the face, trouble breathing, wheezing, and loss of consciousness.

What Are the Four Phases of Suboxone Treatment?

The four phases of suboxone treatment include the induction phase, stabilization phase, maintenance phase, and recovery phase.

Induction Phase

The induction phase occurs under the supervision of a Suboxone physician. In the induction phase, you experience the early stages of withdrawal symptoms. Your doctor will prescribe the lowest Suboxone dosage to reduce your use of opioids without experiencing severe withdrawal symptoms, side effects, or intense cravings.

If you take Suboxone before you enter the early stages of withdrawal symptoms or your system contains the presence of other opioids, Suboxone may cause you to develop acute withdrawal symptoms.

Stabilization Phase

The stabilization phase occurs when you no longer experience intense cravings or severe side effects caused by the lack of opioids. At this stage, your doctor may adjust your Suboxone dosage.

Maintenance Phase

The maintenance phase sees you continuing to take Suboxone while seeking counseling or therapy to help you maintain a clean lifestyle, free of opioids. In this stage, you may also begin the Suboxone taper process, which involves gradually tapering off the medication, making a smoother transition, and decreasing the possibility of relapse.

Recovery Phase

The recovery phase is the last stage of treatment. In this stage, your physician will encourage you to seek counseling and participate in ongoing outpatient programs such as a 12-step program, one-on-one program, or group therapy.

The duration of these phases differs from person to person and your physician will adjust it according to your individual needs. After these four phases end, you will need to go through the medical maintenance phase and long-term recovery phase. These two stages require a great deal of willpower in order to maintain a clean lifestyle, but don’t give up.

How Can You Get Suboxone Treatment?

Suboxone treatment plans begin with a visit to one of the following medical professionals:

  • physicians at a community hospital;
  • physician’s office;
  • physicians at a healthcare department;
  • physicians at a correctional facility.

Are You the Ideal Candidate for Suboxone Treatment?

You are the ideal candidate for Suboxone treatment if the following applies to you:

  • a qualified medical professional has evaluated and diagnosed you with opioid dependence;
  • you are willing to follow safety precautions for Suboxone treatment;
  • you do not have any medical illness that conflicts with using Suboxone, such as lung or liver issues;
  • all other treatment options have been considered.

What Questions Should I Ask My Doctor?

Ask your doctor the following question if you are thinking of using Suboxone to decrease your dependence on opioids:

  • Are you at risk for certain side effects that result from taking Suboxone?
  • How can you decrease the likelihood of experiencing side effects that result from taking Suboxone?
  • Would reducing your Suboxone dosage help alleviate the side effects associated with taking the medication?
  • Are you currently on any other medications that may cause a negative interaction when combined with Suboxone?
  • Should you have any concerns about forming an addiction on Suboxone?
  • When you are ready to stop taking Suboxone, what is the best course of action to take?

It is important that you disclose all your medical history, past illness, and current medications you are taking to your doctor when you consult with him/her about taking Suboxone for treating your opioid addiction.

Should I Be Concerned About Suboxone Abuse?

A 2013 report released by The Drug Abuse Warning on Suboxone abuse and addiction stated:

  • Over three million people in the United States undergo treatment for opiates and opioid addiction by taking Suboxone.
  • From 2006 to 2010, visits to the emergency room due to taking Suboxone increased by 255 percent.
  • More than half of the patients on Suboxone went to the emergency room due to the intentional abuse of the medication.
  • In 2010, around 60 percent of visits to the emergency room occurred due to patients combining Suboxone with other substances.

Even though Suboxone is not supposed to be addictive—as it is meant to fight off opiate and opioid addiction—cases of people developing addiction to it have been reported because of drug abuse. Abusing the medication or mixing it with other substances can cause individuals to develop a sense of dependency on it. This is because everyone reacts to medications in a different manner than others, hence there is a probability of a person on Suboxone forming an addiction to it.

Suboxone Abuse: Methods to Get a Suboxone High

Individuals battling an opioid addiction will look at other ways to get high, and that includes tampering with Suboxone. Since Suboxone contains buprenorphine, which is an opioid drug, some may tamper with Suboxone to change its formula with one of the following methods:

  • by crushing Suboxone tablets to snort it, or by dissolving it in a solution to inject it directly into the bloodstream or to quickly dissolve the medicine in the mouth.
  • by injecting Suboxone tablets into the system by diluting the tablets and then injecting it directly into the bloodstream.

*Note: Injecting Suboxone into the bloodstream can cause instant withdrawal symptoms because naloxone can antagonize the function of other opioid drugs present in the system. Therefore, only take Suboxone tablets as directed by your physician.

Mixing Suboxone with Other Substances

Another way some may abuse Suboxone is to combine the medication with other substances such as alcohol, sedatives and tranquilizers, heroin, and stimulants. When Suboxone pills are mixed with other substances, it increases its effects. It can create a lethal combination and cause their respiratory system to function improperly.

Here’s a list of the common substances used in combination with Suboxone:

  • Suboxone with alcohol is a fatal combination that can cause breathing difficulties.
  • Suboxone with sedatives or tranquilizers (which are types of benzodiazepines) is a fatal combination that can slow down breathing to dangerously low levels.
  • Suboxone with heroin is not a fatal combination, but an unpleasant feeling, as naloxone blocks heroin at the receptors, causing the body to go into rapid withdrawal.
  • Suboxone with stimulants can cause a stimulant overdose because it counters the relaxing effects provided by buprenorphine.

Suboxone is prescribed to those suffering from addiction to help them cope with the withdrawal symptoms and kick their habit. Therefore, abusing Suboxone, either by snorting or injecting it, or by combining it with other substances, defeats the purpose of taking Suboxone.

*Note: Combining these substances with Suboxone, individuals may develop breathing problems, extreme lethargy, and in some extreme cases, even death.

Signs of Suboxone Overdose

Seek immediate medical assistance if you experience any of the following signs of Suboxone overdose:

  • bewilderment;
  • coma;
  • faintness;
  • lethargy;
  • loss of consciousness;
  • slow and labored breathing.

How to Get off Suboxone

Under the guidance of a physican, you will slowly taper off Suboxone. Your healthcare professional will develop a Suboxone taper chart tailored to you. The following Suboxone taper chart is an example of how the process might look if you were on a two-month course, taking a 16mg dose per day:

  • Day #1: An instant reduction of 25 percent means taking 12mg per day;
  • Day #6: Suboxone dosage reduced from 12mg per day to 8mg per day;
  • Day #11: Reduced from 8mg per day to 4mg per day;
  • Day #16: Reduced from 4mg per day to 2mg per day;
  • Day #24: Reduced from 2mg per day to 1.5mg per day;
  • Day #31: Reduced from 1.5mg per day to 1mg per day;
  • Day #39: Reduced from 1mg per day to 0.75mg per day;
  • Day #45: Reduced from 0.75mg per day to 0.5mg per day;
  • Day #51: Reduced from 0.5mg per day to 0.25mg per day;
  • Day #56: Reduced from 0.25mg per day to 0.13mg per day;
  • Day #60: Reduced from 0.13mg per day to 0mg per day.

Suboxone Withdrawal Symptoms

If you suddenly stop taking Suboxone, it can result in negative side effects, which is why it is important to gradually taper off the medication. Additionally, you may experience the following Suboxone withdrawal symptoms:

  • depression and/or anxiety;
  • fever, chills, and sweating;
  • headaches;
  • stomach cramps;
  • diarrhea;
  • nausea and/or vomiting;
  • intense cravings for Suboxone;
  • muscle and body aches;
  • unable to concentrate;
  • unable to fall asleep.

Suboxone withdrawal symptoms can last for one or more months once you stop taking the medication. The first 72 hours without Suboxone are normally the toughest, and it is during this time you may experience vomiting and nausea. Therefore, Suboxone should not be stopped unless directed by your physician.

Suboxone is a highly regulated drug, and any physician prescribing it has, by law, gone through special certification procedures and classes. Most Suboxone clinics or physicians will issue a patient agreement or contract to sign. The agreement will implement drug testing, counseling, and even medication counts to verify non-abuse. When used properly and as prescribed, Suboxone can be an invaluable tool for ending opioid dependency.

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