Suboxone for opioid dependence

What is suboxone?

Buprenorphine is a partial opioid receptor agonist with high affinity for the mu receptors.

 

Buprenorphine attaches to the kappa receptor and slows (antagonize) its activity and induce positive mood and feelings of wellbeing.

How does suboxone work for opioid addiction?

Buprenorphine binds tightly to mu opioid receptors and blocks opioids from reaching the receptors and producing the desired strong effects.

Is suboxone addictive?

There is a myth among opioid users that replacing illicit opioids or prescription narcotics with suboxone is simply replacing one addiction with another. Although long term use of suboxone and methadone would result in dependence on those medications, but several factors need to be taken into account.

First, opopid addiction is a chronic illness.  Taking a prescription medication and being on a therapeutic regimen to manage and treat any chronic condition is not considered addiction.

Second, addiction is defined compulsive drug seeking behaviour and interruption on ovational activities despite harm.

Should I do a short term tapper or should I stay on suboxone for a while?

Current evidence indicates that taper and detox programs failure rate is as high as 85%. Some researches have speculated that rapid taper programs reduce individuals’ tolerance which increases their risk of overdose if they relapse after a taper program.

How much should I take and for how long before I can successfully stop opioid dependence?

The dose and length of treatment needs to be tailored to individuals’ needs based the severity of their dependence which is indicated by the amount, route, dose, type of drugs and length of addiction.

What lab work up do I need to do before starting suboxone?

Before starting suboxone maintenance, your physician will perform some laboratory work up to ensure the safety of your bodily organs.

The following are common works ups:

  1. CBC
  2. BUN, Elect, Cr, eGFR,
  3. Hepatitis A, B, C
  4. HIV
  5. TSH
  6. Uruinalysis
  7. STI
  8. Urine drug screen

Also, it is required to do a baseline ECG to measure the heat conduction value, QTc.

Is suboxone safe?

Suboxone is a safe medication if taken as prescribed. Drinking alcohol or taking benzodiazepines while on suboxone increase the risk of respiratory depression, overdose and death.

If buprenorphine is given to an individual who has already taken another opioid, it displaces the other opioid from the receptors.

What is the safest way to stop suboxone after being sober from opioids for a long time?

Sudden stop of suboxone could result in withdrawal symptoms. It is always recommended that suboxone be tapered off slowly, by no more than 5% to 10% every 2 to 4 weeks. Taper speed would depend on the dose and the length of time that an individual has been taking suboxone. For instance if one has been on 24 mg suboxone daily for a couple of years, it would be safer to taper no more than 2 mg every few weeks.

Important note:

This document is prepared by the “Mental Health for All” team. The general information provided on the Website is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practise medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Website and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Website is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.

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