Suboxone Treatment

The first prescription medication approved by the Food and Drug Administration (FDA) for out-patient opioid dependence treatment, suboxone allows people who are addicted to opiates like Vicodin, Oxycontin, morphine, and heroin to be treated at home and continue their daily lives instead of being treated in a hospital or needing to make daily stops at a clinic.  A combination of naloxone and buprenorphine, suboxone is available in 2 mg and 8 mg dose tablets that are taken by placing them under the tongue and waiting for them to dissolve and be absorbed (usually about five to ten minutes); saliva should not be swallowed while the tablets are dissolving. 

The buprenorphine in suboxone is a partial opioid agonist; as such, its effects are similar to those of Vicodin or heroin (full opioid agonists) but significantly less pronounced.  The manufacturer has incorporated naloxone into suboxone to prevent inappropriate use of suboxone (e.g., changing the method of administration by grinding it and injecting it); if taken as prescribed (orally), it will not be absorbed, but if injected, it will trump the effects of other opiates and the user will begin experiencing withdrawal.  For these reasons, suboxone is considered an effective substitution therapy for opioid dependence.

Suboxone Mechanism of Action

The brain contains numerous chemical receptors that bind to agonist (produces an effect), inverse agonist (produces the opposite effect), or antagonist (blocks an effect) substances.  When a patient takes suboxone, the buprenorphine that it contains binds to the empty opioid receptors thereby satisfying the patient’s physical need for opiates (dependence) and combating cravings.  While buprenorphine remains bound to these receptors, it blocks the binding of other opiate drugs and, by extension, the “high” that addicts feel when using them.

Suboxone Treatment

Because they create severe dependence and unpleasant withdrawal symptoms, opiate addictions have very high relapse rates.  Methadone, another approved substitution therapy for opioid addictions, is more closely regulated because of its potential for abuse or overdose and requires that the patient make daily visits to a clinic to receive the dose.  By contrast, suboxone can be dispensed at a pharmacy and taken at home because the naloxone that it contains reduces the likelihood of abuse and overdose.  Another benefit of suboxone over methadone is that tapering at the end of a program may be easier because suboxone is only a partial as opposed to a full opioid agonist.

When a patient experiences the onset of withdrawal during an office visit, the physician will begin dosing suboxone to determine the appropriate level for maintenance, which is defined as the absence of withdrawal symptoms in combination with the patient returning to or maintaining normal functioning. This dose commonly ranges from 12 mg to 16 mg once daily.  The duration of tapering can vary significantly depending on how much suboxone the patient was receiving.

Suboxone is an excellent treatment option for anyone who is struggling with an opiate addiction.  If you or someone you know may benefit from substitution therapy, ask your doctor about suboxone.