Suboxone is a popularly approved medication to treat opiate withdrawal. It is one of two forms of the medication buprenorphine, which is an opiate agonist originally developed to treat pain problems. Suboxone works by binding to opiate receptors in the brain, which are the same receptors that morphine, heroin and other opiates bind to.
If you are not familiar with Suboxone, you might be more familiar with Methadone. Methadone was an earlier form of harm reduction treatments used to treat heroin addiction. Although Suboxone has treated thousands of patients struggling with opioid addiction, the drug is not without its risks. Critics continue to express concern over the lasting impact of Suboxone use when it comes to increasing dependency.
One huge concern of Suboxone use is the potential side effects of mixing other drugs with the substance. Suboxone can have dangerous interactions with other substances which pose an immediate risk to Suboxone users.
How Suboxone Works
In order to better understand the risk of combining drugs with Suboxone, it is important to understand how the drug works. Suboxone is a combination of the drugs buprenorphine and naloxone. It functions as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s receptors. In other words, even if you try to get high off opioids, you won’t.
Taking other drugs while on Suboxone can be life threatening. If you are on Suboxone, pay very close attention to the following three substances. Combining these drugs with Suboxone can cause a very dangerous, even fatal interaction.
3 Drugs You Should Never Mix With Suboxone:
- Benzodiazepines (“Benzos”)
Benzodiazepines (Xanax, Valium, Klonopin) are drugs usually prescribed to alleviate anxiety and treat insomnia. They are depressant drugs, or “downers,” because they sedate the central nervous system, which slows the heart rate, lowers blood pressure and depresses breathing. Because Suboxone is also a depressant drug, the two together create a double-whammy effect. The combination can cause a severe lack of coordination, impaired judgment, unconsciousness, respiratory failure, and even death.
The effects of Suboxone and cocaine are extremely dangerous because both drugs are on opposite sides of the spectrum. Cocaine is a stimulant, or “upper,” while Suboxone is a depression, or “downer.” When you combine cocaine with Suboxone, it actually reduces the amount of buprenorphine that is in your bloodstream. When you have less buprenorphine in your body, you start to feel opioid withdrawal symptoms.
Combining cocaine with Suboxone increases the risk of a cocaine overdose. Since Suboxone is a depressant, it counteracts the effects of cocaine. This means users end up taking more and more cocaine because they do not feel the effects they normally would on their regular amount. Typically, users start to believe that can handle more cocaine, even when they cannot. The increase in cocaine used can result in an overdose.
Mixing alcohol with any medication is never a good idea, especially Suboxone. Just like benzos, alcohol is a depressant. Alcohol is even more of a problem than benzos because it is so readily available. An uninformed Suboxone user may not even consider the risks of drinking alcohol. However, combining alcohol and Suboxone can produce the same exacerbated effects such as unconsciousness and respiratory failure. These side effects can be dangerous and even fatal.It is so important to know all the risks you are taking with newly prescribed medication. According to statistics, there were 30,135 buprenorphine-related emergency room visits in 2010. It should come as no surprise that 59 percent of these visits involved additional drugs.
As Suboxone’s popularity increases, it is important to understand the dangers of mixing Suboxone with other substances. If you are taking Suboxone or similar drugs, it might be a good idea for you to consider seeking help on going off those drugs completely. Seeking professional treatment can help you not rely on any drugs in your recovery. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
I’m just gonna say this right off the bat…a lot of people aren’t going to like what I have to say about this topic.
There are those people, myself included, who believe that the use of any mood or mind-altering substance is a break in sobriety and therefore anyone using one of these so-called medications, even if prescribed by a doc, cannot be considered to be in recovery.
Then there are others who believe that the use of methadone or Suboxone is a lesser evil than heroin or other opiates and that somehow they can be considered to be sober. I am going to explain a few things about methadone and Suboxone to help clear the air about whether or not people on methadone or Suboxone are truly in recovery.
So, Are People On Methadone or Suboxone “in Recovery?”
Methadone: Synthetic Opiate
First of all, methadone is a Schedule II drug along with oxycodone and morphine. That’s right, they’re both classified just like other opiates. However, methadone and Suboxone are technically classified as ‘opioids.’ The only difference between an opioid and an opiate is that opioids are a synthetic version of opiates. For example, heroin, morphine, and codeine are all derived from the poppy plant and are therefore opiates. Methadone and other narcotic painkillers, such as oxycodone, Opana, and Tramadol are opioids simply because they are the man-made version of heroin and its derivatives.
According to Wikipedia (and all other medical sources), “Methadone…is a synthetic opioid.”Plain and simple.Methadone has what is called ‘cross-tolerance,’ which means that it has tolerance to similar drugs, including heroin and morphine, and causes similar effects as these but with a longer duration of effect. And because it is so similar to morphine or heroin, methadone acts on the same brain receptors as these drugs do, therefore causing many of the same effects; just like with heroin and other opiates and opioids, methadone’s adverse effects include respiratory depression (slowing down of breathing) which is also the mechanism behind fatal overdose, constipation, miosis (pinned pupils), dependence, tolerance, and withdrawal symptoms upon cessation.
Suboxone Contains an Opiate
Suboxone (the name brand for the generic drug Buprenorphine), is scheduled a little differently than methadone as it is considered a Schedule III drug, making it similar to methadone and other opiates and opioids but it considered to have a lower potential for abuse than these others.
Now, in the case of Suboxone, it contains two drugs: an opiate agonist – an actual opiate – and an opiate antagonist, which blocks the action of the opiate. This blocker drug works to block certain brain receptors in order to keep the patient from achieving the same level of euphoria – the ‘high’ – that they would with a straight opiate. It’s kind of like a governor on a car’s engine – it only allows the opiate part of the drug to work to a certain degree.
And, just like with other opioids, the most common adverse effects associated with Suboxone include nausea and vomiting, drowsiness, dizziness, headache, memory loss, cognitive disruption, sweating, itchiness, dry mouth, miosis, decreased libido, and difficulty with urination. Respiratory depression, the most serious adverse reaction related with the use of opiates and opioids, is also associated with Suboxone use, although it isn’t as high of a risk in Suboxone users as it is in people who use other opiates.
Methadone and Suboxone Maintenance Programs
From personal experience with both of these drugs – as a way to treat my opiate dependency and addiction during the decade or so of my active addiction, I will tell you that these programs are misguided. They boast that they can help opiate addicts who otherwise can’t get clean to lead a “normal” life. I see it differently. Big Pharma, methadone and Suboxone clinics and their staffs see desperate opiate addicts as a cash cow, offering a steady stream of income with little work on their part. All they have to do is make empty promises and supply desperately addicted people with their form of legalized dope.
As a person in long term recovery from all mood and mind altering substances, and as someone who had tried both methadone and Suboxone, it is my belief that pure abstinence and successful recovery from opiates and all other illicit and prescription drugs is possible.
The way I was able to achieve sobriety was by getting professional help from a drug and alcohol treatment program. There, I was eased off of Suboxone so as to be as comfortable as possible through the detox process. I then attended a 30 day rehab, which I completed. After that, I received ongoing support and therapy from an IOP. Early on, I became involved in a 12 Step fellowship, which supports me in my ongoing sobriety. If you or someone you love is on methadone maintenance or Suboxone, give us a call toll-free at 1-800-951-6135 where we have Addiction Specialist available around the clock to answer your questions.
Zubsolv is a new name-brand drug being used to treat opiate addiction. It is the same as its predecessor, Suboxone, in that it contains the same two drugs: buprenorphine and naloxone, and it is prescribed for the same reasons.
Drugs containing buprenorphine and naloxone are approved for treating of opiate withdrawal in people who are opiate-dependent. Buprenorphine is an opiate agonist that was originally developed to treat pain problems. Naloxone is an opiate blocker. Medications that contain both are used in addiction treatment because of the way they work: the medication binds to the opiate receptors in the brain, which is the same exact receptor that morphine, heroin and other opiates bind to. The addition of the blocker is to keep the patient from getting ‘high’ from the medication.
Substance Showdown: Zubsolv vs. Suboxone
- Both are prescribed for the treatment of opiate dependence
- Both contain the same two active ingredients: buprenorphine (the partial opiate agonist) and naloxone (the opiate blocker, also added in order to prevent abuse by injection)
- Both are dissolve under your tongue (taken sublingually)
- Both have the same duration – they are generally taken either once or twice daily
Substance Showdown: Zubsolv vs. Suboxone
- Taste – Suboxone has a citrus taste and Zubsolv has a mint-like taste (in at least one study, people preferred the taste and feel of Zubsolv over Suboxone)
- Size and form – Zubsolv is a very small tablet, Suboxone comes as a film
- Absorption – perhaps one of the biggest differences as far as treatment goes, is that Zubsolv has better bioavailability, meaning that it is designed in such a way that the body can absorb it better.
Substance Showdown: Zubsolv vs. Suboxone
Because of the last aforementioned difference, another way in which Suboxone and Zubsolv differ is in their dosing. Since your body can more effectively absorb and make use of the buprenorphine in Zubsolv, the tablets contain slightly less of the active ingredients. With Suboxone tablets and films, the dosages are 2mg/0.5mg and 8mg/2mg buprenorphine/naloxone whereas Zubsolv comes in 1.4mg/0.36mg and 5.7mg/1.4mg. Though the tablet contains less medication, due to Zubsolv’s better bioavailability, your body gets the same useful amount.
Zubsolv is an “advanced sublingual tablet formulation” that “offers higher bioavailability relative to the tablet.” Basically, this means that more of the drug reaches your bloodstream, which then allow you to take a lower daily dose, because that is all you technically need.
Substance Showdown: Zubsolv vs. Suboxone
The truth of the matter is, when either Suboxone or Zubsolv is used for long-term maintenance, rather than for short-term treatment to alleviate withdrawal symptoms, you will continue to be dependent on a substance. Just like when you were using other opiates for which you are now taking (or considering taking) Suboxone or Zubsolv, you can’t simply quit cold turkey – you will also experience withdrawal symptoms. Again, these medications contain a partial opiate.
In both cases, Suboxone and Zubsolv, the medication is a prescription that is used to treat people who are addicted to opioid drugs, such as prescription painkillers or illicit drugs such as heroin. And, they are best used as part of a complete treatment program that also includes counseling and behavioral therapy in order to recover and achieve long-term sobriety.
If you or someone you love is struggling with substance abuse or addiction, or is on Suboxone maintenance or is considering Zubsolv treatment, please call toll-free 1-800-951-6135.
By: Cheryl Steinberg and Nicole Armstrong
The following interview was given by a woman – a mother – who has been around both addiction and recovery most of her life. With one daughter in recovery and another on Suboxone maintenance, we at Palm Partners thought getting a parent’s perspective on the disease of addiction and recovery could be helpful for other parents.
Our interviewee asked to remain anonymous so we’ll call her Susan. Susan grew up in a two-parent household with an older sister. Their father was an active alcoholic and addict for much of her upbringing but now has 30 years of sobriety.
A normie, herself, Susan later married a man who would later die from the disease of addiction. They have two daughters.
Palm Partners: What is your family history with addiction and alcoholism?
Susan: I was raised by an addict and I married an addict and then I raised two addicts. So it’s been a world of experience, so to speak. When I was young, I can remember my mom became active in [Al-Anon] and when I was about 13 years old, she would take us – me and my older sister – to Alateen meetings; even then I didn’t fully understand even though I was given information about the disease. It didn’t really register.
Do you think that addiction is hereditary?
Yes, I definitely think that addiction is hereditary – (jokingly) no, we just got a cursed family tree!
Do you go to any support groups, such as al-anon and was it helpful going to these groups?
I’m not actively attending meetings now but yes I did find it very helpful. For one, I find it very comforting to be able to sit in a room full of other people who I don’t need to explain what’s going on with me to because they understand. Someone can say something and I can totally relate to them and they can totally relate to me.
Do you think the environment contributes to addiction? What’s your opinion on Nature vs. Nurture?
I think [environment] has some effects but I wouldn’t say that it makes you or doesn’t make you an addict; I believe that it is in you. I was exposed to addiction as a child and I went the other way and didn’t become an addict, I became the person who takes care of the addict – the co-dependent. I do believe being in a household with addiction has its affects but does it make you an addict? Absolutely not.
What’s your advice to parents with a child who is actively using?
Go to an Al-Anon meeting and learn all you can about the disease and get support. Also go to an open AA or NA meeting, I found that to be very enlightening.
How did the rest of your family react and deal with addiction?
My sister – since she is less knowledgeable of addiction – her reaction a lot of the time can be anger. My parents always are very supportive and sometimes can be a little co-dependent with me even with all their knowledge. With my husband[‘s addiction] it was very clear cut with getting him well and with my daughters it definitely almost became a NEED for them to be fixed by my father. It became much more important, not sure if that was because of my husband’s death or because he is an addict, too. Almost as if [my dad] felt like it all started with him and spiraled from that; like in some ways he had guilt about it.
Is it an open topic in your family?
Yes, very much so.
What is your experience with a child in recovery and one not in recovery?
Because I believe in recovery and I believe in the program and that it works – I’ve seen it work – that is my wish for both of my children. I try not to judge and as long as I don’t feel one of them is using; I try to be supportive. But because I have seen what recovery can do to transform someone and change their life, that’s what I would want for both of them. I see my recovering daughter and I see the changes in her life, then I see my other daughter and I see some changes in her life but I still feel like she struggles and I don’t [think that] she’s totally happy; I feel that that’s because she hasn’t fully dealt with everything and doesn’t have a proper support system. I feel that is crucial to being able to succeed.
What makes you different?
I’m different when it comes to chemicals, I don’t have that in me. I am the other side of the coin; I am the one that tries to fix [others].
When did you know it wasn’t normal and it had become a problem with your husband and then your children?
With my husband, in some ways I feel like I always knew. I remember going to my first Al-Anon meeting and listening to the other women talk and how they laughed about what their addict was doing and they seemed okay with it and I thought they were crazy. I remember leaving thinking they’re crazy and I’m not going to be one of them. So I went home and was miserable again for a few more years until I went back and thought they’re onto something here and I finally accepted what I already knew.
With my oldest child, I have to honestly say I don’t know how I didn’t know, but I did not know. I must have been living on a cloud or something but, I had no idea and when I found out I was shocked. With my youngest child, it wasn’t until my oldest child entered rehab that I noticed she had a problem [too]. When you have two active addicts, one is always worse and the worse one ends up making the other one look well. When one was really bad, I didn’t notice problems with the other and vice versa. And I think that’s a big problem for people with two children who are addicts.
What are your thoughts on allowing children to experiment with drugs, knowing the family’s history with addiction?
I think the only way that a parent would be okay with that would be because they didn’t have enough knowledge about the consequences.
Do you recommend parents allow kids to drink at home and be open about it?
In a household of people who aren’t a family with a history of addiction, I think that’s okay. I think if a child can see how a normal person interacts with drinking that it can be healthy for them to see that. But that would only work for someone who doesn’t have addiction issues.
What was your best resource when your kids needed help?
My father, in some ways he was probably my crutch because of his knowledge and experience [as a recovering alcoholic/addict].
How do you feel about being the go-to person for help with addiction?
It makes me feel good. It’s nice to be able to share my experience in a positive manner to be able to help other people. With this disease and being a parent, I’ve always felt like when you’re making decisions so many times what feels like is the natural response as a parent, isn’t the best response dealing with an addict. And that is a hard thing for a parent to come to grips with so if I can help them with what I’ve already learned, then that’s a nice feeling.
Did you turn religion or a higher power to cope with everything?
I pray more now and that’s something I didn’t do before. Not religion so much but more of a higher power type of thing.
Did your children have a religious upbringing?
What’s your take on AA and fellowship?
I fully believe in the program of AA and the benefits that can be achieved by going to the meetings and working [the] program. In my experience, it is what appears to make the addict be able to live a happy and healthy life.
What is your take on Suboxone?
For detoxing, I find [Suboxone] to be very beneficial. I believe that it can be beneficial in maintenance related issues in some cases, but I feel that it would really need to be closely monitored because you are dealing with addicts.
If you or a loved one is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135. Palm Partners can help.
Honestly, I totally understand why people want to get on suboxone. The benefits to it are great, and it is especially beneficial if you can’t stop using opiates; but there are many things they don’t tell you about suboxone that should be known. So I made a list of all the things I could think of that the doctors and other people don’t tell you about suboxone.
5 Things No One Tells You about Suboxone: It is meant for short-term use
Usually when you go to the doctor to get prescribed suboxone, people don’t realize that suboxone is really only meant for short-term use to just help you go through the withdrawals. After the withdrawals are over you should stop taking the suboxone. You might think it is just an alternative to using drugs, but it is really only made to help you not feel so sick during your withdrawals!
5 Things No One Tells You about Suboxone: They aren’t trying to just get you off of opiates
It would seem that way, but a lot of doctors will continue to prescribe you suboxone well after the withdrawals from the other drugs have been over. Some will even continue to prescribe it for YEARS. Once again like I said above, it should only be taken for a small period of time. Continuing to be on suboxone is just substituting one drug for another.
5 Things No One Tells You about Suboxone: It is a drug!
Yes, it is a drug! Suboxone is a narcotic which makes it a drug. It is considered a schedule 3 controlled substance. Suboxone contains a combination of buprenorphine and naloxone. Buprenorphine is an opioid medication, and an opioid is a narcotic. You may think it is some magic medicine just made to take away withdrawals, but it is a drug itself and a very addictive one at that.
5 Things No One Tells You about Suboxone: The withdrawals from it are horrible
The withdrawals from suboxone are also ten times worse than the withdrawals from the opiates or heroin you are using suboxone for. If you are on suboxone for an extended period of time, you can end up detoxing from it for anywhere for 10-14 days or more! I’ve personally seen people withdrawing from suboxone and I would take opiate withdrawals over those withdrawals any day of the week.
5 Things No One Tells You about Suboxone: Taking it doesn’t make you sober
This could really be just my opinion but it is one that I and a lot of people in the rooms of AA, NA and CA could probably agree upon. When you’re taking suboxone you are not considered sober to the people in 12-step meetings. Being sober consists of not taking any type of narcotic or using any drugs or alcohol in ANY FORM. I understand that being on suboxone is the closest to being sober that some people have been in a long time, but that doesn’t make you completely sober. Yes, it is great that you are not shooting up heroin anymore, but to be sober you have to get off the suboxone, too. If you or a loved one are struggling with substance abuse or addiction, please call toll free 1-800-951-6135.