Used to treat opioid addiction, Suboxone is a narcotic that also has can be addictive if not taken as instructed. While it is less habit-forming than methadone, it is just one component of opioid addiction recovery, and it has the potential to be just as addictive as the substances it is supposed to curb.
Why is this the case? And just what are the side effects of Suboxone misuse? Let’s take a more in-depth look.
What Is Suboxone?
Suboxone (one of the brand names for buprenorphine and naloxone) is a narcotic substance that is commonly used in the medication-assisted treatment of opioid addiction. Typically, a combination of Suboxone and counseling and behavioral therapies are used in order to treat opioid addiction. It has been shown to help some people sustain their recovery process.
Suboxone is a combination of two drugs: buprenorphine (the active component) and naloxone (the drug that blocks the effects of opioids, which is also referred to as the opioid antagonist). Buprenorphine is a partial opioid agonist, meaning that it essentially functions as an opioid. However, this is weaker than opioids like methadone and heroin and has a “ceiling effect.” A ceiling effect basically means that the opioid effects level off even as dosages increase. This makes the drug less likely to be misused and become addictive. It also reduces the withdrawal effects of opioids and the cravings to use them without having the same high potency as opioids. Overall, buprenorphine is designed to help keep people from taking other opioids.
Naloxone is, as already mentioned, Suboxone’s opioid antagonist. The only time it will become activated within the body is if it is injected as opposed to being orally ingested (which is how Suboxone is prescribed to be taken). Should someone inject naloxone into the bloodstream, it will trigger some rather unpleasant withdrawal effects. This is meant to serve as a way to discourage people who are addicted to intravenously using drugs from injecting Suboxone. If they try it once, there is a good chance that they will not want to do it again.
Opioid Addiction Symptoms
So, how can you tell if your loved one is addicted to an opioid and might benefit from rehabilitation? Here are some of the most common symptoms of opioid addiction to be aware of:
- Struggling to quit opioid use despite its negative impact on one’s health and relationships
- Forgoing your favorite activities in order to use opioids
- Feeling compelled to use more opioids in order to achieve the same desired effect
- Experiencing withdrawal symptoms (such as a runny nose, irritable mood, sweating, nausea, vomiting, shaking, diarrhea, anxiety, and body aches) when not using opioids
- Wanting to but not being able to decrease the amount of opioids used
- Spending the majority of your time trying to find a way to get and use opioids
Why Might Suboxone Be Addictive?
Suboxone’s effects are mild at best since this drug is used to treat opioid addiction. This drug has a slow onset and can last for a long time. This is why it is a lot less addictive than drugs like heroin and methadone. The risk of becoming addicted to Suboxone itself is relatively low. Also, as a patient progresses through their drug addiction treatment, the Suboxone dosage will be tapered off as a way to help resolve the person’s dependency.
Naloxone, of course, will only be effective if there are already opioids in a person’s system. It is there to counteract the depressive effects that opioids have, which can help keep a person’s breathing and blood circulation stable.
Suboxone might be misused on rare occasions if a person feels compelled to use opioids but has no access to anything else. In inpatient treatment, medication-assisted therapy is highly regulated, so a person who is battling opioid addiction will not be able to access any substance. Should someone doing outpatient or partial hospitalization misuse Suboxone, they will likely be highly disappointed in the results and may not try to misuse it again.
Does Suboxone Generate Any Side Effects?
Since buprenorphine has effects similar to but milder than opioids like heroin, it can produce some side effects that might be rather unpleasant. The typical side effects include:
- Muscle cramps and aches
- Irritable mood
- Loss of sleep
Naloxone also has some side effects, which can include:
- Sneezing and a runny nose
- Chills and fever
- Stomach pain
- Irritable mood
- Body aches
People who are prescribed Suboxone should not stop taking it until their doctor tells them to do so. Suboxone should never be started without a proper prescription from a doctor. If it is taken too soon after opioid use, Suboxone can produce side effects such as a runny nose, irritability, anxiety, diarrhea, vomiting, body aches, nausea, shaking, and sweating. When a person feels ready to stop their dosage, they should first consult with their doctor to see if indeed this might be appropriate. A doctor can best help you make this determination and help you avoid some moderately painful side effects.
While missing a dose will not necessarily trigger any serious side effects, it can increase the likelihood of a relapse. When taken as prescribed, there are some side effects that can happen. Respiratory depression is one of the most serious side effects since it can lead to death. However, it is considerably rare. The risk for developing it does increase when a person taking Suboxone injects it into the body or mixes it with other depressants, such as alcohol. Mixing it with other benzodiazepines (such as alprazolam or lorazepam) can also trigger respiratory depression since this puts too many depressants into the body at once and slows down the functions of the whole nervous system. Should you or the person you are taking care of start to experience dizziness, excessive fatigue, difficulty breathing, or become completely unresponsive, medical attention needs to be sought immediately.
Suboxone does not function as a pain reliever and should certainly not be used as such. Of course, as already stated, it should not be injected. Instead, it needs to be taken orally and as prescribed. A few deaths have been reported in individuals who had never used opioids before shortly after using low doses of Suboxone.
Who Should Not Take Suboxone
People who are diagnosed with liver disease should refrain from taking Suboxone because of how it acts on the liver. Luckily, for everyone else, liver injury from taking suboxone is relatively unheard-of. Anyone with signs of jaundice (yellowing of the eyes and skin), severe vomiting or nausea, or severe stomach aches or pains should call their doctor and report their symptoms.
Some medications are known to interact with Suboxone, which is why it is important that your doctor and pharmacist both know that you are taking it. You might be asked to stop taking certain medications that have known interactions or might not be able to take Suboxone due to those potential interactions. This is especially true for anyone taking meds like:
Suboxone does have a few known serious interactions with certain diseases, aside from liver disease. Those with impaired GI mobility, gastrointestinal obstruction, respiratory depression, infectious diarrhea, CV disorders, acute MI, and intracranial pressure are all known to have negative reactions to Suboxone. And, of course, mixing alcohol with Suboxone is never recommended since they are both depressants that could lead to respiratory distress.
The 3 Phases of Suboxone Treatment
Three main phases exist for how Suboxone is administered. The initial phase – which is often referred to as the induction phase – must be administered between 12 and 24 hours after a person has used opioids. The second is the stabilization phase, which lessens the degree of cravings a person experiences. At this point, the person should have discontinued or at least greatly reduced their opioid use. Some timing and dosage adjustments might need to be made, but the maintenance phase should be commenced if this stage proves to be successful. The maintenance phase is pretty self-explanatory; it is all about maintaining abstinence from opioid usage and working through treatment.
There are some alternatives to taking Suboxone. Naltrexone (brand name Vivitrol) is an extended-release, once-per-month injection. Studies have shown that Naltrexone produces fewer side-effect instances than Suboxone. However, these studies also show that naltrexone’s potency might not be as effective at curbing the cravings for opioids as Suboxone. In one study, Suboxone users had a 14-week average relapse time while naltrexone users had an average of eight weeks.
The difficulty with naltrexone is getting people started on it. Suboxone offers a pretty strong starting dosage and makes it easier to taper down as a person progresses through each of the three phases. Naltrexone requires that a person waits several days after opioid use to start it, which makes it all the more difficult to get started. Suboxone only requires about 12-24 hours. On average, in a clinical setting, these two drugs should fare similarly in treating people with opioid addiction, but Suboxone can be started more quickly.
Treatment for Opioid Addiction
In-patient, outpatient, and partial hospitalization options are all available for those who are dealing with opioid use. Once a person enters a detox program, they might receive medication-assisted therapy with Suboxone. 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.
Typically, a combination of Suboxone and counseling seems to work best at preventing future relapse. Cognitive behavioral therapy (or CBT for short) is known for its efficacy in treating opioid addiction since it addresses the unrealistic thought patterns that center around addiction and teaches the person how to substitute in realistic and helpful thoughts.
We can help you with your own struggles with opioid abuse. Contact us at Granite Recovery Centers today.