Suboxone is a medication that is FDA-approved to treat opioid use disorder. Providers and patients often misunderstand it. Despite being on the market since 2002 and being listed on the World Health Organization’s List of Essential Medicines, questions still swirl around its role in addiction treatment. Suboxone falls under a general umbrella of medications called MAT, which stands for Medication Assisted Treatment. Medication Assisted Treatment encompasses medicines that are FDA-approved for the long-term treatment of substance use disorders. These medications are designed to be used in combination with psychotherapy and non-medication support tools for long-term recovery and recurrence prevention. Here are some of the most common questions on Suboxone:
How does suboxone help me or my loved one get and stay sober?
Opioid Use Disorder is notorious for long, protracted, severe physical withdrawal symptoms. Unlike Alcohol Use Disorder, which has a shorter withdrawal period, folks suffering from Opioid Use Disorder often experience withdrawal symptoms, including nausea, vomiting, diarrhea, dry heaves, cold sweats, and muscle aches for up to 14 days after the time of last opioid use. Even after these physical symptoms subside, folks who have previously struggled with opioids often continue to have very intense, daily opioid cravings for years. Suboxone sets folks up for success in long-term recovery by eliminating all opioid physical withdrawal symptoms and opioid cravings so people feel better.
How does Suboxone work?
Suboxone is what is called a partial opioid agonist. This is a fancy way of saying it contains just enough low-dose opioid ingredients to treat physical withdrawal symptoms and cravings while being less abusable than “full” opioids like Oxycontin, Dilaudid, Vicodin, and Fentanyl.
How effective is Suboxone?
Studies show that folks suffering from moderate to severe Opioid Use Disorder have up to a 95% recurrence rate in the first year of recovery without Suboxone. This means that if you put 100 people in a room who struggle with opioids and recently quit, only 5 of them would not experience a recurrence or return to use within one year. I don’t know about you, but I wouldn’t say I like those odds. I want my patient and/or loved one in the room of folks who are taking suboxone. Suboxone also decreases the risk of death by overdose by over 80%. That’s pretty incredible.
Are you still sober on Suboxone? Isn’t it addictive?
Since suboxone contains a small amount of a very weak opioid, many family members worry that their loved one is still “addicted” while taking suboxone. This misconception is amplified by the observation that when patients stop taking suboxone, they also experience physical withdrawal symptoms. People hearing this often equate Suboxone to older prescribed opioids like oxycontin, fentanyl, and Dilaudid, which cause physical dependence and can also lead to abuse and misuse. It’s tempting (and natural) to think that Suboxone carries the same risks. However, unlike other opioids, Suboxone has a built-in “ceiling effect,” so you can’t get a euphoric “high” with escalating doses.
Is Suboxone abusable?
Suboxone contains a small amount of the opioid blocker Naloxone. This is the same ingredient found in Narcan that is used to reverse opioid overdoses. The Naloxone/Narcan stays inactive unless a patient tries to inject Suboxone. If someone tries to inject Suboxone via IV, the Naloxone immediately activates and prevents the Suboxone from attaching to opioid receptors in the body, thus preventing abuse. Additionally, Suboxone is a sublingual medication. This means it is taken by placing the medication under the tongue and letting it slowly dissolve into the saliva. This absorption method slows the medication release and activation speed, thus also reducing abuse potential.
How do you get off Suboxone?
Once patients are on effective doses of Suboxone, they can work with their physician to slowly reduce the dose and taper off completely when the time is right for them. When to get off of Suboxone is an individualized decision that should be carefully considered with patient, family, and provider input. It’s tempting to taper off of Suboxone after a few days or weeks of sobriety. However, shorter lengths of time on Suboxone often correlate to higher risks of recurrence. As a general rule of thumb, I usually suggest that patients stay on Suboxone for at least twice as long as their duration of active substance abuse. It’s also ok for folks to stay on Suboxone indefinitely. Addiction is a lifelong journey. It is essential to master the non-medication recurrence prevention skills needed to remain sober before starting a Suboxone taper.
Is Suboxone right for me?
In general, if you or your loved one struggles with noticeable, significant physical withdrawal symptoms when trying to stop opioids, Suboxone could be a critical addition to your recovery journey. This addition will substantially increase your chances of success while significantly decreasing your risk of death. That’s a win-win.
As with any individualized medication guidance, talking to your healthcare professional about your specific situation is essential. In general, Suboxone is a very underestimated and underutilized medication that can often make the difference between long-term success with recovery and a path filled with frequent pitfalls and stumbles.
Aware Recovery Care is Here to Help
If you or a loved one is struggling with an addiction to opioids, other drugs, and/or alcohol and need help in Maine, New Hampshire, Massachusetts, Connecticut, Rhode Island, Virginia, Georgia, Florida, Ohio, Kentucky, or Indiana, the recovery teams at Aware Recovery Care are here to help. And we come to you, regardless of where you live. Our unique in-home treatment model of care gives clients a significantly better chance of recovery than traditional inpatient rehab care. We are now offering Virtual Detox and Medication Assisted Treatment in New Hampshire, Connecticut, Virginia, Georgia, Indiana, Kentucky, and Ohio as well. Please get in touch with one of our Recovery Specialists to learn more.
About the author…Dr. Lauren Grawert MD.
Dr. Grawert is a double board-certified Addiction Psychiatrist. She completed her medical school training in 2009 and a General Psychiatry Residency in 2013 at the Medical University of South Carolina (MUSC). She then went on to complete an Addiction Psychiatry fellowship at MUSC, which she completed in 2014. After fellowship training, Dr. Grawert served as the Chief of Psychiatry and Addiction at Kaiser Permanente of the Mid-Atlantic. She has also worked in private practice specializing in general psychiatry, substance use disorders, and medically assisted treatment (MAT). Dr. Grawert has served as an expert for the San Diego Community Response to Drug Overdose Task Force, the Addiction Committee Leader for Kaiser Permanente National Mental Health & Addiction Leadership Organization, and a Professor of Psychiatry at Penn State College of Medicine. She likes to write, travel, and spend time with her two young children in her spare time.
