In 2002, the FDA approved the use of the unique opioid buprenorphine (Suboxone) for the treatment of opioid addiction in the U.S.
Buprenorphine has numerous advantages over methadone and naltrexone.
As part of a medication-assisted treatment, it suppresses withdrawal symptoms and cravings for opioids, does not cause euphoria in the opioid-dependent patient, and it blocks the effects of the other (problem) opioids for at least 24 hours.
There are two medications combined in each dose of Suboxone.
The most important ingredient is buprenorphine, which is classified as a ‘partial opioid agonist,’ and the second is naloxone which is an ‘opioid antagonist’ or an opioid blocker.
As an opioid partial agonist, buprenorphine can produce typical opioid agonist effects such as euphoria and respiratory depression.
However, its effects are less than those of full agonists like Oxycodone, hydrocodone, morphine, heroin and methadone, which are examples of ‘full opioid agonists.’
When taken at low doses, a ‘partial opioid’ produces sufficient agonist effect that allows opioid-addicted individuals to discontinue the use of other opioids without experiencing withdrawal symptoms.
Suboxone, when taken properly, may feel help a patient feel a very slight pleasurable sensation, but most patient report that they feel “normal” or “more energized” during medication-assisted treatment.
This includes much needed relief from various withdrawal symptoms and cravings.
The agonist effects of Suboxone increase with increasing doses of the drug until at moderate doses, and is metabolized by the liver and has a half-life of 24–60 hours.
This long duration of activity may allow some patients to medicate every other day, as opposed to the daily dosing required in methadone treatment.
People who are already opioid dependent do not get a euphoric effect or feel high when they take Suboxone properly.
Suboxone tricks the brain into thinking that a full opioid like oxycodone or heroin is in the lock, and this suppresses the withdrawal symptoms and cravings associated with that problem opioid.
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.