Frequently Asked Questions

What are Opioids|Opiates?

In medicine, the term opiate can refer to any of the narcotic painkilling drugs with opium-like effects, both natural, and fully or semi-synthetic. Traditionally, opiate refers only to the narcotic drugs that are naturally present in opium.

A more appropriate umbrella term for all of the drugs derived from opium, both natural and synthetic, would be opioids. Opioids get their name from the fact that they are found in, or derived from drugs that are found in opium, which is the processed resin of the opium poppy (Papaver somniferum).

Many common opioids include:

  • Codeine
  • Hydrocodone (Vicodin, Hycodan)
  • Morphine (MS Contin, Kadian)
  • Oxycodone (Oxycontin, Percoset)
  • Hydromorphone (Dilaudid)
  • Fentanyl (Duragesic)

Continuous use of opioids can cause opioid dependance, leading to symptoms of opioid withdrawal with abrupt discontinuation. Opioids are well known for their ability to produce a feeling of euphoria, which is a mental and emotional state of intense well-being and happiness. This is one of the reasons some choose to use opioids recreationally, which can often lead to opioid addiction.

What is an Opiate Withdrawal?

While Opioid withdrawal can be extremely uncomfortable, it's important to remember that it is not life threatening if you are withdrawing only from opioids, and not a combination of drugs

There are two stages of withdrawal. The first stage, the acute stage, usually lasts at most a few weeks. During this stage, a patient may experience physical withdrawal symptoms. But every drug, and person, is different.

The second stage of withdrawal is the Post Acute Withdrawal Syndrome (PAWS). During this stage patients tend to have have fewer physical symptoms, but more emotional and psychological withdrawal symptoms instead.

Post-acute withdrawal occurs because a patient's brain chemistry is gradually returning itself to normal. As the brain chemical levels improves, chemicals fluctuate as they normalize, causing post-acute withdrawal symptoms.

What are Withdrawal Symptoms?

There many physical and emotional withdrawal symptons associated with opiate and drug addiction:

Physical Withdrawal Symptoms

  • Sweating
  • Racing heart
  • Palpitations
  • Muscle tension
  • Tightness in the chest
  • Difficulty breathing
  • Tremors
  • Nausea, vomiting, or diarrhea

Emotional Withdrawal Symptoms

  • Anxiety
  • Restlessness
  • Irritability
  • Insomnia
  • Headaches
  • Poor concentration
  • Depression
  • Social isolation

What is Medically Assisted Treatment?

Medication-assisted treatment for opioid dependence can include the use of buprenorphine (Suboxone) to complement the education, counseling and other support measures that focus on the behavioral aspects of opioid addiction. Suboxone helps patients to normalize the brain's chemical levels, and return a state of mind free of withdrawal and cravings. Medication-assisted treatment for opioid addiction and dependence is much like using medication to treat chronic illnesses such as heart disease or diabetes. Taking medication for opioid addiction is not the same as substituting one addictive drug for another.

Medically assisted treatment using Suboxone commonly involves three phases: induction, stabilization, and maintenance. The induction phase is the medically monitored start-up of addiction therapy.

Suboxone is first administered when an opioid-addicted individual has abstained from using opioids for 12–24 hours and is in the early stages of opioid withdrawal. This is done to ensure that the Suboxone does not cause the patient to enter into early acute withdrawal. Treatment then continues as part of our addiction recovery process, with observed treatment and personalized care.

Afterwards, during the stabilization phase, the Suboxone dose is adjusted until a patient has either discontinued, or greatly reduced the use of other opioids, and is no longer experiencing cravings. Once a steady dose is reached, the patient enters the maintenance phase. The length of time of the maintenance phase will vary from patient to patient as every person is unique in their addiction.

What is Suboxone and How Does it Work?

Suboxone is a medication used to treat opioid dependence, containing buprenorphine and naloxone. According to the World Health Organization, an estimated 15 million people suffer from opioid dependence. Buprenorphine and naloxone, formulated as Suboxone, are used to treat this dependence.

What is Buprenorphine?

Buprenorphine is considered a “partial opioid agonist,” meaning that it produces a milder form of the effects produced by opioids (which are “full opioid agonists”). It essentially fills the brain’s opioids receptors without producing the same high as full opioids. One of the advantages of using Suboxone is that it cannot be taken to achieve a full opioid effect, making it more difficult to abuse than other forms of medication-assisted treatment, such as methadone.

What is a ‘Partial Opioid Agonist’?

A ‘partial opioid agonist’ such as buprenorphine is an opioid that produces less of an effect than a full opioid when it attaches to an opioid receptor in the brain. Oxycodone, hydrocodone, morphine, heroin and methadone are examples of ‘full opioid agonists.’ For the sake of simplicity from this point on we will refer to buprenorphine (Suboxone) as a ‘partial opioid’ and all the problem opioids like oxycodone and heroin as ‘full opioids.’ When a ‘partial opioid’ like Suboxone is taken, the person may feel a very slight pleasurable sensation, but most people report that they just feel “normal” or “more energized” during medication-assisted treatment. If they are having pain they will notice some partial pain relief.

Why Combine Buprenorphine and Naloxone?

The reason for combining buprenorphine and naloxone is that it reduces the risk of intravenous use. Suboxone is supposed to be taken as a tablet and held under the tongue. But if Suboxone is dissolved and taken intravenously, the naloxone reverses the effects of the buprenorphine, which blocks the high. Therefore there is less danger of diversion.

What are the Dangers of Using Suboxone?

While Suboxone is an excellent resource for those seeking recovery from opiate addiction, like all medications, it has its disadvantages. Aside from possible side effects, Suboxone is typically a drug that users take for a long time to maintain recovery. As a partial opioid agonist, it still allows some opioid dependence in users. As a result, when users aim to get off Suboxone, they should taper their dosage under medical supervision.