Author: Justin Mckibben
Suboxone is a medication meant to treat opiate and opioid 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.
Is Suboxone Safe: How Suboxone Works
In order to better understand the risks of Suboxone use, it is important to understand how this medication works. Let us be clear, Suboxone is a narcotic. It is a semi-synthetic opioid made from a combination of two drugs:
This compound is intended for the treatment of pain, as well as for combating opioid addiction. However, what many people don’t realize it that buprenorphine is itself an opioid.
DEA reports show that the substance can be 20-30 times more potent than morphine as an analgesic; like morphine buprenorphine can create a dose-related euphoria. Like other opioids commonly abuse, buprenorphine is capable of producing a significant “high” and thus has been abused in various ways.
Now, all products containing buprenorphine are controlled substances. Given the nature of this powerful opioid, the other primary compound of Suboxone is added.
Naloxone is a pure opioid antagonist medication used to block the effects of opioids. It works by reversing the depression of the central nervous system and respiratory system. Narcan is a brand name for the medication that is commonly utilized as an overdose antidote.
But beyond being used to reverse overdoses, the addition of naloxone to products like Suboxone is with the intention of blocking the euphoric high resulting from the abuse of opioids by injection, like buprenorphine.
So when a drug like Suboxone is taken orally, just the opioid has affect. Naloxone blocks the impact of the opioid when it is injected. The primary purpose of naloxone in Suboxone is to deter intravenous abuse.
Is Suboxone Safe: How is it used?
Suboxone acts as a partial opioid agonist and diminishes cravings as well as prevents other opioids from reacting to the brain’s receptors. The drug has become a frequently utilized substance for trying to combat opioid addiction. Suboxone can come in tablet form, or in the form of a film taken sublingually, meaning dissolved under the tongue.
When taken orally or sublingually as directed, the naloxone is not absorbed and the buprenorphine acts uninhibited. However, the formulation still has potential for abuse. Published data has shown that the opioid receptor’s binding affinity to buprenorphine is higher, so the opioid typically overrides the antagonist, causing many reports to argue that naloxone is an insufficient deterrent for the injection of Suboxone for recreational abuse.
Serious dangers of Suboxone
While Suboxone may have become a mainstream tactic for combating opioid addiction, the question has become if it is as safe and effective as producers would have us believe. So when presented with the question of ‘is Suboxone safe?’ must look at a few factors.
Is Suboxone Safe: Adverse side-effects
The fact remains that Suboxone is an opioid narcotic. Therefore, the side-effects of Suboxone are essentially the same as other opioids.
Most common minor side-effects include:
- Mild dizziness
- Stomach pain
- Redness, pain or numbness in the mouth
- Trouble concentrating
Most common major side-effects include:
- Cough or hoarseness
- Feeling faint or lightheaded
- Feeling of warmth or heat
- Fever or chills
- Lower back or side pain
- Painful or difficult urination
Major side-effects suggest the individual should check with their doctor immediately.
Is Suboxone Safe: Withdrawal symptoms
The irony is that Suboxone is typically used because people are trying to stop abusing other illicit or prescription opioids but want to have something to curb the withdrawal symptoms. Yet, Suboxone is known to have its own withdrawals, and for some they are even worse.
Symptoms of Suboxone withdrawal can include:
- Body and muscle aches
- Difficulty concentrating
- Drug cravings
- Digestive distress
The physical withdrawals can peak in the first 72 hours after the last dose, and some of the more psychological symptoms can last much longer.
Is Suboxone Safe: Interactions with other drugs
Taking other drugs while on Suboxone, especially other opioids or sedatives, can actually be fatal. Combining Suboxone with other drugs can cause a very dangerous reactions that many also ignore. Drugs that are particularly dangerous with Suboxone are:
- Benzodiazepines (Benzos) such as Xanax
- Older Antihistamines
- Antipsychotics such as Zyprexa
Cocaine is also an extremely hazardous drug to combine with Suboxone because they are opposites on the spectrum of stimulant vs depressant. When you combine cocaine with Suboxone, it actually reduces the amount of buprenorphine that is in your bloodstream. With less buprenorphine in the body the effects of opioid withdrawal symptoms can be felt.
Combining cocaine with Suboxone also increases the risk of overdosing on cocaine.
If you would like more information on Suboxone, download our free E-book: 5 Things No One Tells You about Suboxone.
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Is Suboxone safe?
Suboxone may be a legal and popular alternative to some other opioids, but that doesn’t necessarily make it all that ‘safe’ to rely on. It is of course possible to overdose on Suboxone. As we said before, Suboxone combined with other drugs can also be incredibly dangerous. And at the end of the day, you can still become psychically and psychologically dependent on the drug.
In truth, Suboxone has been useful to some who have tried to get off of drugs like heroin and other dangerous opioids by providing a buffer and some method of harm reduction. But the often overlooked aspect is that Suboxone is only intended for short-term use and not long-term maintenance. When individuals use the substance for long periods of time, they become dependent on it just like any other potent narcotic. Experts insist that Suboxone and similar drugs are only effective in combination with comprehensive treatment or cognitive behavioral therapy.
For more information, read our
A safer and far more healthy and sustainable approach to recovery from opioid addiction is with holistic treatment that offers much more than an opioid substitute with its own adverse effects. If you or someone you love is struggling, please call toll-free now. We want to help.
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(This content is being used for illustrative purposes only; any person depicted in the content is a model)
Author: Justin Mckibben
Addiction is not an easy problem to address. It is a complex issue with many variables, so of course there is no simple answer to fix it. There is no one-size-fits-all solution; no monopoly on the right kind of treatment. It is understandable that there is a degree of effectiveness with utilizing any medical means available to try and address addiction, but are maintenance drugs really the answer?
Surely medication assisted treatment is useful, and it helps a lot of people. Most inpatient treatment programs utilize some form of medication to ease withdrawal symptoms and other side-effects of long-term drug use. The detox period of treatment usually focuses on medically assisting someone struggling with drugs in this transition.
However, is getting people off of one drug by making them dependent on another really the best case scenario? It seems now insurance companies are putting more effort into using maintenance drugs to treat addiction. Is this really a better strategy?
Firstly, let us make a clear definition of what maintenance drugs are. Typically, the definition of maintenance drugs is along the lines of prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines.
Examples of common maintenance drugs are medications such as:
- Fluticasone and salmeterol (Advair Diskus) which is used to treat asthma
- Insulin glargine (Lantus) used to treat diabetes
If you consider these examples the point is that people use these medications to “manage” their illness, not to overcome or remedy it. So looking at the issue of addiction, there are some well-known maintenance drugs, specifically concerning opioid addiction.
These medications can be effective, but they also present a level of danger themselves. Even though doctors prescribe them to combat withdrawals, they actually can create their own devastating withdrawals, especially with long term use.
Aetna Aims for Maintenance Drugs
Aetna is one of the nation’s largest insurance companies. In a recent Aetna report, the company is prepared to remove a major restriction for patients seeking maintenance drugs for opioid addiction. The change is set to begin this coming March. Aetna is the third major health insurer to announce such a shift in policy in recent months, now in league with Anthem and Cigna insurers.
To be more specific, this insurance company will stop requiring doctors to seek approval before they prescribe particular medications that are used to combat withdrawal symptoms. One of these medications is suboxone, a well-known medication that many people use to fight opiate addiction.
The common insurance practice is known as “prior authorization”. The reason they are seeking to eliminate this policy is because it sometimes results in delays of hours to days before a patient can get the medications.
This new approach to regulation of maintenance drugs impacts all its private insurance plans, an Aetna spokeswoman confirmed.
Advocates of Maintenance Drugs
Addiction treatment advocates to support having expanded access to maintenance drugs. Dr. Corey Waller, an emergency physician who chairs the American Society of Addiction Medicine’s legislative advocacy committee, states:
“It’s a first-line, Food and Drug Administration-approved therapy for a disease with a known mortality. [For] every other disease with a known mortality, the first-line drugs are available right away.”
Essentially, the idea that parity laws require insurers to cover addiction treatments at the same level as other kinds of healthcare means these kinds of medication should be available for immediate access. This should be the same for all forms of addiction treatment.
Opinion: Treatment over Maintenance
While many would argue that maintenance drugs are a form of treatment, it is still a relevant argument that maintenance drugs are also imperfect and could actually be harmful if they become the cookie-cutter answer implemented by most insurers.
While harm reduction is understandable, and maintenance drugs can help people struggling with heroin or other dangerous opioids avoid other serious risks, the fact is many maintenance drugs include their own side-effects. Some often become subject to abuse themselves.
For instance, suboxone can be useful as a harm reduction tactic, but it can also be abused. Many people who have used suboxone as a long-term solution have found themselves battling suboxone withdrawal symptoms. The dangers of suboxone are very relevant.
The same, if not worse, has often been said about methadone maintenance drugs. While they may keep someone alive to get treatment, there should still be a strong emphasis on treatment itself. Maintenance drugs are most effective when part of a program. They are not a substitute for a treatment program.
Treatment should focus on finding solutions, not prolonging the suffering. Drug and alcohol addiction treatment should come from a holistic approach that addresses more than just physical ailments. Holistic treatment focuses on providing extensive and personalized therapy, combined with physical and emotional heal. If insurance companies want to focus on combining rational medical resources with comprehensive treatment, then this could be a great thing. However, if the focus becomes a quick-fix drug option opposing a full recovery through treatment, it only adds to the danger.
Maintenance drugs have support from the recovery community, but typically they must be accompanied by therapy and other means of treatment. Maintenance drugs are just that- drugs. They are often powerful narcotics, and are true to their title- “maintenance,” not a permanent solution.
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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.