Suboxone is a drug that was approved in 2002 by the FDA to be used as a form of medication-assisted treatment for addiction to opiates like heroin, OxyContin, hydrocodone, morphine and others.
Suboxone contains a mixture of two drugs:
- Buprenorphine: a synthetic opiate that helps prevent withdrawal symptoms after the addict stops using the addictive opiate drug of choice
- Naloxone: a drug that blocks the euphoric effects of opiates
When Suboxone was originally approved as a medication-assisted treatment for opiate dependence, it was available in the form of sublingual tablets that were designed to be dissolved under the tongue. Recently, Suboxone has also become available by prescription in the form of a film that comes in 2 mg, 4 mg, 8 mg and 12 mg doses. This dissolving film is advertised as more discreet than the tablets and it contains the same active ingredients as the sublingual tablets.
When undergoing medication-assisted treatment for opiate abuse, an addict cannot feel the desired “high” when taking other opiate drugs while Suboxone remains in the body. The buprenorphine in Suboxone fools the brain into thinking the user took a narcotic drug (heroin, OxyContin, etc.) so cravings and withdrawal symptoms are suppressed during treatment.
Why Suboxone Addiction Occurs
Although users can’t actually get “high” from using Suboxone, it is possible to become addicted to the medication. Addiction to Suboxone can occur if the user abuses the medication or takes it between “highs” from other opiate drugs to alleviate withdrawal symptoms. When a patient is prescribed Suboxone for a prolonged period of time, the body can build up a tolerance to it, as well. This means the user will need to take more of it in order to achieve the desired effect.
Addiction is particularly risky if the user abruptly ceases taking Suboxone or stops taking it too soon. When this happens, painful Suboxone withdrawal symptoms may occur. Because of this, it is extremely important that addicts adhere to their doctor’s instructions when weaning off the drug.
Side Effects of Suboxone Abuse
One of the characteristics of Suboxone is its “ceiling effect.” This means the effectiveness of the drug does not increase if the user takes a higher-than-prescribed dosage. However, if the addict tries to manipulate the Suboxone in order to achieve a desired effect, this is a sign of abuse. Attempts to manipulate a drug include things like chewing pills or crushing them in order to snort or inject them.
Like any other type of opiate, one of the dangerous side effects of Suboxone abuse is respiratory suppression (stop breathing). Typically, this is a risk for addicts who take Suboxone in conjunction with benzodiazepines or alcohol.
Other side effects of Suboxone abuse include:
- Constricted pupils
- Watery eyes
- Increased blood pressure
- Impaired motor functions
- Slowed heart rate
- Slurred speech
- Poor memory
- Apathetic mood
In addition to these physical side effects, prolonged Suboxone abuse can cause serious damage to the addict’s liver or kidneys.
Suboxone Withdrawal Symptoms
For many addicts, the withdrawal symptoms of Suboxone can be just as difficult to manage as the symptoms of quitting the opiate drug for which Suboxone was originally prescribed. Several factors influence the severity and duration of Suboxone withdrawal symptoms, such as:
- The amount of Suboxone taken each day
- The duration of Suboxone use
- The individual’s body chemistry
- The manner in which the user ceased taking Suboxone (e.g. quit cold turkey or tapered off the drug)
Generally, individuals are tapered off Suboxone under medical supervision in order to lessen withdrawal symptoms. When a patient stops taking Suboxone, common withdrawal symptoms include:
Body Aches and Pain
It’s common for patients to experience body aches and pain when quitting Suboxone. If you were prescribed Suboxone to help with chronic pain, the withdrawal pain you experience may be more severe at first. This happens because your body has grown accustomed to letting Suboxone take care of the pain for you, instead of allowing endorphins, your brain’s natural painkillers, to kick in. The good news is that your pain will gradually lessen as your body heals itself during the withdrawal process.
When coming off Suboxone, it’s normal to experience flu-like symptoms such as nausea, runny nose, sweating, fatigue and diarrhea. While these symptoms can be quite uncomfortable during the early stages of detox, it’s important to understand that, over time, these symptoms will pass.
Some drug users experience a sense of panic and anxiety when first withdrawing from Suboxone. This is partially due to the fact that Suboxone tends to produce a calming effect in the brain. When the addict first stops taking the medication, it can induce temporary feelings of anxiety.
Confusion and Lack of Focus
You may feel an overall sense of confusion after quitting Suboxone, making it difficult to focus on tasks like work and school. Suboxone influences the brain’s neurotransmitters, so your body just needs time to sort itself out and adjust to the lack of Suboxone in your system.
As you come off the drug, it’s normal to feel more depressed than usual. Suboxone has been known to help alleviate depression by aiding in the production of endorphins in the brain. When you cease taking Suboxone, your endorphin levels naturally drop, which can result in feelings of depression or hopelessness. Try to remember this is just a natural part of the withdrawal process as your body begins to heal itself from the physiological effects of addiction.
While taking Suboxone, your body relied on the drug for energy so you could complete all of your daily tasks. After quitting Suboxone, it’s normal to feel excessively tired, sleepy or fatigued while your body physically withdraws from the drug. As your mind and body heal, take heart in knowing that your energy will return.
Irritability and Mood Swings
Some people feel irritable, moody or discouraged while the brain repairs itself from the effects of Suboxone dependence. Although mood swings and irritability can be tough to cope with at times, keep in mind that these symptoms are natural signs of the healing that your body is accomplishing right now. Over time, your mood will stabilize and your irritability will subside.
Many users experience restlessness during early Suboxone withdrawal. If you already suffer from occasional bouts of restless leg syndrome, you may experience similar feelings when first coming off the drug. If you’ve never experienced restless legs before, this is a condition that creates an uncomfortable feeling in the legs than can only be alleviated when you move them around.
Suboxone is an extremely powerful Schedule III medication, so you should expect cravings to take place while your body withdraws from the drug. Dealing with Suboxone withdrawal symptoms can induce urges and cravings, but they are temporary. Everyone is different, so there’s no way to estimate exactly how long your cravings will last. Just try to remember that these experiences are temporary and speak with your doctor about your withdrawal symptoms.
Suboxone Rehab and Recovery
One of the best available tools for overcoming your dependence on Suboxone is a good addiction counselor or therapist. For some addicts, attending an in-patient rehab facility that specializes in opiate addiction is the most effective way to begin recovery and undergo a medically assisted Suboxone detox program. Sometimes, removing yourself from the outside world for a short time is the easiest way to completely focus on your own health and recovery.
It’s crucial that you try to open up and speak honestly about your addiction with your counselor, especially during the most difficult times. This may feel awkward or uncomfortable at first, but it will become easier the longer you work with your therapist. When embarking on an outpatient recovery program, you might even decide to attend multiple sessions with your therapist each week to help you avoid making impulsive decisions when you feel triggered or cravings set in.
A Suboxone addiction recovery program can help you better understand the drug so you may explore non-narcotic alternatives for managing pain and overcoming your opiate dependence. Plus, you can work with your therapist to examine personal and emotional issues that may have led to your original opiate addiction or exacerbated the problem. Detoxing from Suboxone is only one aspect of recovery; a successful recovery program includes healing both the physical aspects of dependence (including detox), and the mental and emotional aspects of addiction.
"Obstacles are those frightful things you see when you take your eyes off your goal."