Over the last few decades, Medication for Addiction Treatment (MAT) has proven effective for treating individuals with opioid use disorder (OUD).
One medication, Suboxone (containing buprenorphine and naloxone), greatly reduces a patient's risk of relapse and helps maintain abstinence.[1] Suboxone has also consistently been shown to work just as well as methadone without the burden of going to a methadone clinic daily to get dosed.
Getting set up with a Suboxone prescription, at least initially, can be difficult. You'll need to find a doctor who can prescribe it, and you'll need to attend regular (usually monthly) visits. You will also need to ensure that you have a pharmacy that provides Suboxone.
What Are the Requirements for Doctors to Prescribe Suboxone?
To prescribe Suboxone, doctors must go through a few additional steps. While all medical doctors can prescribe medications, Suboxone, at least in certain states, requires an additional waiver, which means a doctor must do an additional 8 hours of training in order to prescribe. However, in recent years, many states have eliminated this “waiver requirement”.
How Do You Obtain Suboxone?
Patients can get a prescription for Suboxone from a DEA-waivered physician in any treatment setting (like other prescriptions) and take the medicine at home.
This is very different from methadone, the other FDA approved medication for OUD, which can only be dispensed at a methadone clinic.
As a result, Suboxone often represents an easier, more convenient, and less stigmatizing solution for patients seeking access to treatment for OUD.
Who Is Eligible for Suboxone Treatment?
If you have OUD, Suboxone will be a good medication choice to prevent cravings, withdrawal symptoms, and overdose.
You can take Suboxone if you are the following:
- Pregnant: Suboxone is safe to use while pregnant, and you can keep taking your medication after the birth too.
- Older: Patients must be at least 16 years old to take Suboxone, although there may be exceptions to this in cases where patients are experiencing addiction at a young age.
- Meeting Criteria for an OUD: You must meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for opioid use disorder (OUD), determined via a comprehensive medical assessment.
- Stable: Your team must ensure that you have access to housing, safe living conditions, and enough social support to help you be successful in your recovery.
Who Is Ineligible for Suboxone Treatment?
Some people aren't right for Suboxone treatment. If you meet some conditions, your doctor might look for another treatment type for you.
People who are probably not ideal candidates for Suboxone are any of the following:
- Struggling with severe mental illness: If you have serious, severe, and uncontrolled/untreated psychiatric problems (such as thoughts of suicide or active psychosis), it may not be appropriate to initiate Suboxone treatment.
- Addicted to alcohol: Alcohol acts as a depressant, slowing your body's central nervous system. When Suboxone and alcohol mix, there is an increased risk of sedation, difficulty breathing, overdose, and death.[3] While you can drink in moderation while taking Suboxone, someone with severe alcohol use disorder may not be a good candidate for concurrent treatment with Suboxone.
- Polypharmacy/misuse of other medications: If you misuse benzodiazepines, sedatives, or hypnotics, Suboxone treatment may have to be postponed. Suboxone can cause some sedation at first, so taking it with other sedating drugs can lead to overdose, which can be dangerous. While it is possible to take benzodiazepines or other sedatives with Suboxone, doing so should be done with particular caution and always with guidance/supervision of a physician.
- Allergic: Patients should not be prescribed Suboxone if they have a known allergy or hypersensitivity to buprenorphine. However, this is quite rare.
What to Expect When Starting Suboxone Treatment
The best time to start Suboxone is when you are experiencing withdrawal symptoms, usually somewhere between 12 to 24 hours after using opioids. Chills, nausea, pain, and headaches are all signs that your body is ready to start Suboxone.
In some programs, you'll start your medication in a supervised setting. At others, you may be counseled how to take your first dose in the comfort of your own home. This is usually a decision you and your doctor can make together.
Going forward, most patients have monthly visit for checking in and refills of Suboxone prescriptions.
How Long Will Suboxone Treatment Last?
Each person is unique, as is their treatment plan. Some people use Suboxone for just a few months, while others may use it indefinitely.
Addiction is a chronic condition, and research shows that patients who stay on Suboxone long term are more likely to be opioid-free long term as well.[4]
Conversely, studies demonstrate that within one month of stopping treatment, more than 50% of patients relapse to illicit opioid use.[5]
It is safe to stay on Suboxone for many years, particularly if a patient feels it is helping them to sustain abstinence. However, if you desire to taper off Suboxone, consult with your medical provider to slowly taper your dose, as this will help prevent withdrawal symptoms.
All Your Suboxone Questions Answered
If you have questions about opioids, opioid use disorder, treatments, or other Suboxone-related questions, browse through our Suboxone FAQs. To learn whether telemedicine Suboxone treatment is a good fit for you, call us at (844) 943-2514 or schedule an appointment here.
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