Suboxone, generically buprenorphine, is a controlled substance that is approved by the Food and Drug Administration (FDA) to treat those suffering from opioid use disorder (OUD). Treatment with Suboxone is done via medication-assisted treatment (MAT) in drug rehabilitation facilities skilled to administer the medication. This semisynthetic opioid is an effective way to treat individuals who are addicted to other opioids such as heroin. Suboxone was created as an alternative to methadone, which is another MAT drug.
Suboxone was not initially intended to be used for addiction. The drug buprenorphine was created in the mid-60s as an alternate pain reliever to morphine. At the time, morphine was known to have dangerous side effects as well as being very addictive. Buprenorphine was introduced as a way to reduce pain without all the side effects or possible addiction.
Early on in its creation, researchers did have initial ideas that the drug could possibly help those addicted to narcotics. Although this was known, it would take another 30 years before buprenorphine would be offered as a way to help treat addiction.
What Does Suboxone Do?
Suboxone is the combination of a partial opioid agonist (buprenorphine) and opioid antagonist (naloxone) that helps to reduce the effects of cravings and withdrawal symptoms as an individual goes through a detox program. It can be prescribed and dispensed in a physician’s office via buprenorphine waiver certifications. Although Suboxone is a Schedule III controlled substance that is made up of buprenorphine and naloxone, it is still misused. Naloxone (Narcan) is an opioid antagonist and is paired with buprenorphine to deter abuse; therefore, its risk for abuse is low but still possible. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.
Other forms of buprenorphine include controlled substances such as Subutex (tablets), Zubsolv (tablets), Bunavail (buccal film), Probuphine (implant), and Sublocade (extended-release injection). As for Suboxone, it generally comes in a sublingual film that is placed in the mouth under the tongue. It is held there until it has fully dissolved.
In recent years, Suboxone has become a part of the opioid epidemic because, when paired with other substances, it can cause intoxication. Suboxone on its own cannot generally cause intoxication for those who are opioid-dependent.
Side Effects: Common and Serious
Common Side Effects
- Nausea, vomiting, and constipation
- Fever, muscle aches, and cramps
- Dilation of pupils or blurred vision
- Sweating, tremors, and heart palpitations
- Inability to pay attention
Serious Side Effects
- Pain at the site if injected
- Respiratory issues or distress
- Itching, swelling, pain, and nerve damage for implants
- NAS-Neonatal abstinence syndrome in newborn babies
- Adrenal insufficiency
Suboxone and Pregnancy
Noted above, NAS is possible with the use of Suboxone. Mothers who use Suboxone have a risk of their child having this syndrome. NAS symptoms include tremors, seizures, hyperactive reflexes, tight muscles, high-pitched or excessive crying, vomiting, diarrhea, dehydration, sweating, fevers, and trouble sleeping. Children with NAS tend to feed poorly and can also be at risk for several types of birth defects such as:
- Congenital heart defects: abnormal heart formation and structure
- Hydrocephaly: an excessive buildup of spinal fluid that sits on the brain
- Gastroschisis: a hole in the abdominal wall where the baby’s intestines stick out
- Spina bifida: the spinal cord does not develop properly
In cases of heroin addiction, medical providers may recommend Suboxone because it is safer to expose the fetus to that rather than heroin.
How Long Does Suboxone Stay in Your System?
The period of time that Suboxone stays in the body is 37 hours. For Suboxone to be completely out of your system will take up to eight days. After that, Suboxone is, generally, no longer detectable in the body.
Testing for Suboxone includes blood, saliva, urine, and hair. Blood testing has a very small window of detection but can be used two hours after ingestion. As for other testing methods, continue reading below for further information.
Saliva tests are the most convenient, non-invasive way to detect Suboxone. Saliva testing can be done within a few days or up to a week post use.
Testing via urine is the most common form of detection for Suboxone. Buprenorphine is detectable in urine within an hour of ingestion. Suboxone will show up in urine for up to two weeks from last use for heavy users of the drug.
Hair Follicle Testing
Suboxone is detectable in hair follicles for up to three months from last use. This form of testing is not the most reliable and is not used very often.
Factors Affecting How Suboxone is Metabolized
There are several factors that will affect how long Suboxone stays in your system, and they have to do with when the drug test is taken, the dose, hydration, a person’s metabolism and overall health, their body mass/fat index, and the amount of exercise they participate in daily.
In regards to a person’s metabolism, if it is fast, the drug is broken down and metabolized quickly. A person’s metabolism is dependent on age, gender, genetic predispositions, and environmental factors. To note, if the liver has any previous issues or damage, Suboxone may stay in the system longer. If this is the case, the detection window can last for weeks after the last use.
Treating Opioid Use Disorder With an Opioid
Because opiate addiction is so strong, the safest and best way to provide treatment is through weaning off with a similar yet diluted drug. Someone who has possibly become mentally and physically reliant on opioids is in danger of overdose. This can happen either unintentionally or when taken with other drugs or alcohol.
Addiction to opiates not only requires therapy, counseling, and support but also a medication-assisted treatment program.
Someone who does not have a tolerance to opioids could find themselves experiencing euphoric effects when taking Suboxone. Most often, Suboxone mixed with alcohol or other drugs can cause intoxication or overdose. Symptoms of overdose include
- Abdominal pain
- Nausea and vomiting
- Coma or death
- Depressed breathing
- Slowed heartbeat
- Loss of physical coordination
- Irritability, mood swings, and anxiety
- Unable to remember things or concentrate
There are several drugs that do not mix with Suboxone, and they are benzodiazepines, antidepressants, hormonal contraceptives, barbiturates, and phenobarbital. Benzodiazepines such as Xanax, Klonopin, or Valium are some of the most dangerous drugs to mix with Suboxone. Benzodiazepines are fast-acting anti-anxiety medications, and when mixed with Suboxone, they can lead to hospitalization or death.
Detoxing From Suboxone
Being dependent on Suboxone, physically or mentally, will require detox, treatment, and aftercare. A detox program with medical professionals monitoring intake and gradually coming off Suboxone will be the first step in recovery.
Withdrawal Symptoms of Suboxone
Withdrawal can take up to a month to subside. The first 72 hours of Suboxone withdrawal can be the hardest. Below, we have provided a general timeline of symptoms. Remember that every person’s body is different, and experiences will vary. In some cases, certain symptoms can last either weeks or months.
- 72 hours – Acute physical symptoms (nausea, vomiting, headaches, digestive distress)
- 7 days – Sub-acute physical symptoms (body aches/pains, mood swings, anxiety, insomnia, irritability)
- 2 weeks – Psychological symptoms (depression, anxiety, hard to concentrate)
- 1 month – Psychological symptoms (depression continues, cravings)
The time it takes for withdrawal symptoms and cravings to pass will be based on a few things, such as how long someone has used Suboxone and the amount and if their addiction includes other substances or alcohol.
For many with opioid use disorder, the use of Suboxone is temporary and generally comes without any risk as long as the medication intake is being monitored and not abused.
When the medication that is supposed to be helping with treatment becomes the object of addiction, the process in which one comes off Suboxone will be slow and gradual, and a new path of recovery will be charted.
Treating Suboxone Addiction
As mentioned above, recovering from Suboxone addiction may require medication-assisted treatment to help deal with withdrawal symptoms and the cravings that exist with opioid use disorders. Inpatient detox and rehabilitation will help if the addiction is acute.
For sub-acute addiction, there are outpatient programs after detox. Both of these programs will include monitoring and administering Suboxone. This will allow the individual the ability to come off the medication slowly as they focus on their recovery.
Determining if an individual should participate in a medication-assisted treatment program will require knowledge of time passed since last use, if the individual is using other medications, and if the individual is a danger to themselves or others.
It is also important to establish if the person needs a medical intervention based on their use of Suboxone. If addiction to Suboxone occurred during treatment for another addiction, then an intervention may be needed.
Inpatient Drug Rehabilitation Programs
Inpatient treatment is often needed more so than outpatient in regards to Suboxone addiction. Relapse prevention provides the patient a residential facility to stay in while they take part in therapies such as behavioral, holistic, and psychotherapy.
Therapy and counseling can be done solo or in a group, along with helping patients build life and community skills and exercise. Sessions with patients are generally focused on recovery and utilizing a 12-step curriculum.
Considered a broad category of skills, relapse prevention is key to helping addicts recover. Factors such as stress, a person’s attitude, mental health, environmental, and social all play a role in the risk of relapse.
At Granite Recovery Centers, we offer a variety of programs and therapies to help with Suboxone addiction. From 24-hour support staff to providing safety and structure, our focus is to help you succeed at recovery and gain your life back. Our focus on relapse prevention includes
- Cognitive Therapy
- Mindfulness-Based Relapse Prevention
- 12-step work
- Teaching Lifestyle Choices and Habits
Granite Recovery Centers provides aftercare and extended care programs to those in recovery so that an individual can transition and gain sober living. Although independent living can be rewarding and exciting, it can also seem daunting, especially at first. Our dedicated staff is here to guide and support you with resources that will help you reach your recovery goals.
Granite Recovery Centers focuses on the patient and their individual needs. From detox to therapy and all the way through to aftercare, we are here to teach you and guide you every step of the way.
Located in the New England area, our facilities in New Hampshire are filled with dedicated professionals who are passionate, educated, and well versed in addiction and every phase of recovery. If you are struggling with addiction, please call us.