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Suboxone is an evidence-based medication that can help people recover from opioid use disorder (OUD). Suboxone can be a lifesaving medication for many people when used as part of a Medication for Addiction Treatment (MAT) program.
If your loved one is taking Suboxone, it could get them on the path to a better, healthier future.
What Is Suboxone?
Suboxone is a brand-name medication that combines the drugs buprenorphine and naloxone.[1]
Buprenorphine is a “partial” opioid agonist, a type of drug with similar properties to full opioid agonists like morphine or heroin. Similarly to these medications, it binds to opioid receptors in the brain. This allows the drug to suppress a person’s opioid cravings and prevent withdrawal, but without the same level of misuse or addiction potential present in “full” opioids.
Naloxone is also included in Suboxone in an inactive form. When taken sublingually as intended, it is not absorbed into the body and does not play any role. If, however, a person attempts to misuse the Suboxone strip by dissolving and injecting it, the naloxone enters the bloodstream and binds to opioid receptors preferentially over the Buprenorphine, preventing the person from getting “high” and also preventing an overdose. In this way, it is included in the Suboxone strip as an additional safety mechanism/abuse deterrent.
What to Expect During Suboxone Treatment
Once you decide along with a medical provider to start Suboxone, you will take Suboxone on a prescribed schedule and should follow the instructions you’re given carefully.
While people who are not used to taking opioids (“opioid naïve”) may experience euphoria or drowsiness when taking this drug, most people who have used opioids before (“opioid experienced”) will be unlikely to experience these effects because their body is well accustomed to the opioid class of medications.
As with any medication, Suboxone has some potential side effects. Some rare but possible side effects associated with Suboxone use include:
- Constipation or other intestinal issues
- Headache
- Nausea and vomiting
- Difficulty with attention
- Sleepiness
- Dry mouth
- Fever
- Problems sleeping/insomnia
- Erectile dysfunction
- Excessive sweating
- Tooth decay
Be aware that many of these side effects will be temporary as your body gets used to the medication and will go away on their own. If you experience any symptoms more long term, talk with your prescribing doctor. They may adjust your dose to lessen side effects.
Remember, Suboxone will make it easier to avoid drug misuse, but it won’t “cure” your addiction. There is no cure for addiction, as it is a chronic condition that needs to be continually managed. Medications like Suboxone work best when combined with other types of addiction treatment, notably therapy and other types of behavioral and social support.
Common Myths Surrounding Suboxone Treatment
The following are some common misconceptions relating to Suboxone and addiction treatment in general:
Myth #1: Addiction Is a Curable Disease
While some people are able to achieve long term abstinence and be in remission, we generally think of addiction as a chronic, lifelong condition. While this can feel disheartening, many chronic conditions are effectively managed for life, such as diabetes and heart disease. There is no “cure” for addiction in the sense that there is no guarantee that someone will “never” use again, but people can certainly reach sustained and even lifelong remission, particularly through the use of MAT.
Myth #2: Suboxone Treatment Is Just Trading One Addiction for Another
On a logical level, this misconception makes some sense. Suboxone treatments and several other types of MAT usually involve taking medication sometimes indefinitely. Drugs like buprenorphine and methadone, two common medications used to manage opioid use disorder, are opioids themselves. However, on a practical level, this is very different than “trading one addiction for another.”
Addiction leads people to compulsively take drugs for the temporary relief they may provide, even as those drugs seriously impact their health and quality of life. The drug misuse caused by OUD is almost never well-regimented. The person who is struggling with OUD often feels like they have lost control.
Meanwhile, MAT is a well-regimented treatment plan where a person takes medications as prescribed. These medications are evidence-based, having verifiably been shown to help people regain control over their drug use and improve their quality of life and their ability to function.
Myth #3: People in Recovery Shouldn’t Be Trusted With Suboxone
Suboxone and other buprenorphine-based medications have low misuse potential. As an opioid partial agonist, buprenorphine has much less intense effects compared to drugs like heroin or morphine.
One recent study found that buprenorphine misuse has also been trending downward.[2] Among those who did misuse buprenorphine, many did it to relieve pain rather than achieve a euphoric high. While still ill-advised, as you should only take buprenorphine-based medications as prescribed, this is a notably different kind of drug misuse than is typically associated with opioid misuse.
On a more basic level, buprenorphine-based treatments work in a way that is proven by multiple studies spanning at least two decades. People in recovery from OUD are less likely to misuse opioids when taking drugs like Suboxone compared to those that are not.
Myth #4: The Only Way to Treat Addiction Is by Going Cold Turkey
Abstinence-based treatment, where a person stops taking a drug “cold turkey,” has been shown in multiple studies to be less effective than Medication for Addiction Treatment, using Suboxone and methadone. Almost all experts in addiction treatment these days agree that MAT is a significantly more effective treatment than “abstinence only” approaches.
Myth #5: Suboxone Treatment Doesn’t Work
This myth is verifiably untrue. Suboxone treatments don’t work for everyone, but no addiction treatment does. Just like not every pain medication works the same for pain in different individuals, not every addiction treatment works equally well in different individuals. Some individuals find Suboxone truly life saving while others do not experience as much relief or may experience side effects.
However, when we look at large studies of people using Buprenorphine-based medications, it is clear that for the majority of people, Suboxone works to treat OUD.
Myth #6: Suboxone Users Aren’t Sober
It is true that Suboxone is an opioid, albeit a weak one. Suboxone might produce a mild high in someone who is truly opioid naïve. However, particularly for patients who are used to taking full opioids, Suboxone rarely produces any euphoria or “high”. Instead, patients report simply feeling “normal” when taking it. In fact, this is how it works to help stabilize people and allow them to return to activities of daily living.
Myth #7: Suboxone Treatment Represents a Lack of Willpower to Overcome Addiction”
This misconception reflects a common mistake when discussing addiction treatment. It would be like saying “a diabetic doesn’t have the willpower to simply avoid eating sugary foods”. Even Diabetics who eat incredibly healthy still have higher blood sugars than non-diabetics, and may require medication. We do not call this a “moral failing” or a lack of willpower, and likewise we should not think of addiction disorders as moral failing either.
Even if a Diabetic patient has a very healthy diet, they may need medications to control their blood sugars. Likewise, even if a patient with an OUD has a strong desire and willpower to avoid drug use, they may need medications to prevent their cravings. This is a more productive way for us to think about addiction.
Myth #8: My Loved One Should Only Be on Suboxone for a Short Period & Come Off as Soon as Possible
While not everyone needs to take Suboxone long term, everyone’s timeline is different. Pressuring someone to stop taking Suboxone too soon increases their risk of a relapse. Studies show that people who are in treatment longer (at least six months, and sometimes years or even indefinitely) tend to have lower rates of relapse and return to drug use. Any decision to stop taking Suboxone should be made jointly between the person in recovery and the medical professionals treating their OUD. Ideally, it is best to avoid pressuring a friend or loved one into coming off of medications too soon or before they are very stable in their recovery.
Ways to Support a Loved One on Suboxone Treatment
Supporting someone you love in any kind of addiction recovery program can be difficult. A good place to start is by doing your research: look at articles produced by the Substance Abuse and Mental Health Services Administration (SAMHSA), such as their article on buprenorphine (referenced above) or other reliable sources of online information.
Asking your loved one in a non-judgmental and open minded way about their perspective and experiences can help you to understand their struggles more clearly. Asking them “what can I do to be helpful to you during this time?” can be a good place to start.
There are a plethora of online and in person support groups for friends and loved ones of individuals in recovery. Reach out to your doctor or your loved one’s doctor if you think a support group or online community might be helpful for you as a support person.
If you are still unsure as to how to support your loved one, reach out to us here at Bicycle Health.
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