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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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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Author: Justin Mckibben
Depression can be a prison of grief, disconnection and utter loss of interest that takes hold of someone in the most powerful and oppressive ways imaginable. While sorrow and feeling low are normal facets of the life we all share, the emptiness and hopelessness that can accompany depression is often a far deeper and more severe shade of sadness.
Depression can be difficult to understand, and difficult to treat. There are numerous methods of treatment out there, from anti-depressant medication or personal and behavioral therapy, designed to help diagnose, assess and treat depression, and as time marches on we see many respond, while others struggle and regress.
Now there is a new treatment plan being researched and developed that is actually pretty intriguing, because it includes painkillers, and a medication commonly used to combat addiction… for painkillers?!
Mice and Medicine
Currently a lot of antidepressants are considered selective serotonin reuptake inhibitors (SSRI) which are primarily utilized in treating depression by method of medication. In fact somewhere between 30% and 50% of people being treated for depression with medication use SSRI’s.
Still there is a real demand for newer depression therapies, as many people taking SSRIs do not respond adequately to them, and with severe cases of depression some worry there is too much of a risk of harmful results before treatment can be effective.
Recently scientists at the University of Bath in England conducted research on mice, and their findings suggest by combining a painkiller commonly used after surgery with a drug used to off-set the adverse effects of fighting addiction may be a new and efficient antidepressant treatment.
The ingredients, which have spurred quite an interesting conversation, are:
This is a painkiller that works by reducing a person’s response to stress by inhibiting the kappa opioid receptor in the brain.
However, buprenorphine also stimulates another receptor called the mu opioid receptor. This reaction could actually cause a person to develop a physical addiction to buprenorphine, especially after an extended period of use.
Buprenorphine is also one of the key ingredients in suboxone, which surprisingly is a medication containing naloxone and used to fight opiate addiction.
This anti-addiction drug was added as a result of the dangers with buprenorphine. You may recognize it under the trade name Vivitrol, which is a version that comes as a once-monthly extended-release injectable formulation.
Naltrexone is a drug that blocks the mu opioid receptor in the brain, and is commonly marketed to help fight opiate addiction and alcohol dependence. This medication is also frequently sold under the trade names Revia and Depade.
Details of Study
According to the report on the research published in the Journal of Psychopharmacology when the combination was used on the mice the concoction produced an antidepressant effect, but results showed it came without any addiction issues.
Of course this new combo is not a fool-proof system as of yet. There is still a very long way to go before a buprenorphine-naltrexone mixed medication could be available to every day consumers. Mice is one thing, but humans are very different, so of course there needs to be human trials to determine whether there are any risks.
The study’s co-author Stephen Husbands, PhD, made a statement where he said:
“It may be hard to deliver this combination in the clinic because of the properties of these drugs. We have also been working on changing the chemistry of buprenorphine so that it has the properties of this combination treatment in one molecule which should simplify drug delivery.”
So while we can see a glimmer of hope, there is still some room for curiosity and concern when it comes to taking drugs so closely associated with addiction and combining them as a medicine, especially as a treatment for mental health.
It is understandable how this kind of formula would put people on edge. Combining a powerful opiate with another medication that is used to combat opiate addiction (but also doesn’t have the best reputation for recovery results) probably seems a bit sketchy to people who are trying to find a way to escape depression. I guess only time will tell if this is a surprise innovation or a nightmare disguised as a miracle.
Then you have to ask, what are the odds that humans will develop addictions to these drugs? What kind of new substance abuse could this kind of collision of chemicals create?
Depression and drug addiction often come hand in hand, and treatment can come in many forms. Dual diagnosis treatment is best for co-existing disorders such as these, and beyond medication there is a lot more that can be done holistically to ensure lasting and fulfilled 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.
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.