Suboxone is a combination product used to help opioid addicts stay clean from heroin and other opioids. It contains buprenorphine, a synthetic opioid, and naloxone, a drug used to reverse opioid overdose. The naloxone is there to prevent potential intravenous abuse of the buprenorphine. When taken orally as directed, buprenorphine rarely causes euphoria in opioid-tolerant individuals. The small amount of naloxone in Suboxone won’t have much oral effect, either.
How Suboxone Works
Suboxone works by attaching to the same brain receptors that other opioids do. It controls withdrawal symptoms and drug cravings, allowing the former addict to live a normal lifestyle. However, Suboxone isn’t a full narcotic agonist. This means that it doesn’t attach to the brain’s receptors in the same way as full narcotic agonists like oxycodone do. That’s one reason Suboxone causes much less euphoria, if any, to occur. There is also a ceiling effect. This means that after a certain dose, the drug will produce no further effect.
Suboxone has a very long half-life. Up to 37 hours after a single dose, half of it is still active in the body. It also blocks the brain’s receptor sites for up to three days after a single dose. This means that other opioids can have no effect during this time. While this is a desirable effect in some ways for the recovering addict, it also means that in the case of an emergency, further pain relief would not be possible until the buprenorphine molecules finally released from the brain’s opioid receptor sites.
Although considered less addictive than most other opioids, Suboxone can still produce disturbing withdrawal symptoms. These symptoms may be less intense than those of other stronger opioids, but they tend to last longer. These symptoms include:
- Nausea and vomiting
- Intense drug cravings
- Muscle and bone pain
Suboxone Taper Time
If you ever decide you want to quit Suboxone, know that it won’t be a cake walk. Sudden stoppage of this drug is not recommended. You can expect a Suboxone taper to last a full 30 to 90 days and even longer. This is mainly because of the drug’s long half-life. It takes time for the drug to leave your body when the half-life is so long. The longer you have taken Suboxone, and the higher the dose, the harder and longer the tapering period will be.
You can expect some level of withdrawal symptoms even during a properly paced taper. However, if done correctly, most of the more severe symptoms should be abated. You should be able to at least function in your normal life. If not, seek medical advice for an adjustment of your tapering schedule.
Remember, a Suboxone taper is not a contest to see how fast you can accomplish it. A taper is a way to stop using the drug with minimal discomfort. Everyone is different. Your taper isn’t the same anyone else’s. It will take as long as it takes for you.
Before you begin to take this drug, anticipate the day when you may want to stop. Use the lowest possible dose and don’t stay on the medication longer than necessary.
Methadone Instead of Suboxone?
Another opioid maintenance option is methadone. Methadone is also a synthetic opioid, but it’s a full agonist, not a partial one. There is no ceiling effect. Ingesting more methadone will result in more effects, including overdose. Methadone cannot be prescribed by a doctor for opioid maintenance purposes. There are small dosage forms available that any doctor can prescribe for pain, but knowingly prescribing methadone for an opioid addict is illegal.
If you decide to use methadone, you will need to get it in a special methadone clinic. Here, the doctor is specially licensed to dispense methadone for opioid maintenance purposes. These clinics tend to be rather scarce in many communities. The residents don’t want them there. You may find that the nearest one is a two-hour drive or more away. This is a problem. You will need to visit the clinic daily to get your dose. Methadone maintenance may not be available in all states.
Suboxone is prescribed by specially licensed doctors, but there is no need to attend a clinic daily to get it. Your Suboxone doctor will give you a prescription for a full month’s supply. You can fill it at any pharmacy that stocks it. The pharmacy cannot tell anyone that you are getting this drug, so it’s confidential. No one will know unless you tell them.
Methadone maintenance is confidential as well, but it’s different. You must go to the clinic every day to get your dose. You will not receive a prescription for the medication. Some clinics will allow a limited number of take-home doses after you have complied with their program for a certain amount of time. The clinic will observe you when you come in for signs of illegal drug use. They can and will drug-test you at any time. If you refuse, they can discharge you from the program.
Methadone clinics often operate during strange hours, especially on weekends. They may offer medication times very early in the morning, such as five in the morning to eight in the morning. If you fail to appear during the correct time, you will not get your dose until the next day.
Methadone has one major advantage over Suboxone. Suboxone isn’t strong enough to help every person who tries it. However, the correct dose of methadone will alleviate withdrawal symptoms and drug cravings in virtually everyone. The clinic’s staff will monitor your dose and continue to raise it over time until you are comfortable.
Methadone is extremely addicting. It has a long half-life. That’s why it can be dosed only once a day. A methadone taper will be just as long as a Suboxone one, and probably harder.
If you’re trying to stop using opioids or other drugs, we can help. We are professional counselors, and we are available 24 hours a day. Just call us at 866-802-6848 and let us help you make the best treatment choices for you.