Suboxone Addiction

Americans are developing prescription opiate addictions at an alarming rate. The 2014 National Survey on Drug Use and Health indicated about 1.9 million Americans had a prescription painkillers use disorder. Unlike the illicit opioid heroin, doctors frequently prescribe painkillers to people suffering from painful injuries. For example, if a person fractured their arm in a car accident, a doctor may prescribe them the opioid painkiller OxyContin. Whether a person begins using illicit or prescribed opioids, they can develop addiction disease. In recent years, medications have been synthesized expressly to treat opioid addiction through drug replacement therapy. The opioid partial agonist Suboxone is among them. Just like pure opioids themselves, Suboxone can be habit-forming. Read further for additional Suboxone information, including details on the drug’s chemical behavior and abuse potential.
Suboxone, the trade name for buprenorphine and naloxone mixtures, is a manmade drug used to treat opioid addiction. Millions of Americans have received Suboxone treatment under medical supervision. Suboxone is called an opioid partial agonist because it binds to the same brain receptors as opioids but is not an opioid itself. Because of this action, Suboxone can be used to replace more harmful drugs, such as heroin.

The medication not only serves to reduce opioid cravings, but also helps to suppress the symptoms of withdrawal. Ultimately, Suboxone is used in medical settings to help an addict stop using opioids, get through treatment, then remain in recovery. The FDA approved Suboxone in 2002 for the sole purpose of treating opioid addiction. It was first sold under the name Subutex, which was discontinued in 2011. A generic version of Subutex was available by 2009. A generic version of Suboxone was available by 2012. Since its release, Suboxone has been dispensed under additional brand names:

  • Suboxone Film
  • Buprenex
  • Cizdol
  • Temgesic
  • Buprenex
  • Norspan
  • Butrans
  • Zubsolv
  • Bunavail
  • Probuphine
At first, Suboxone was only available in tablet form; it looked like most any other small white pill. Eight years after Suboxone was first sold in the U.S., manufacturers moved beyond pills to release more innovating formulations including Suboxone strips that look like a postage stamp. Some more creative formulations of Suboxone include:

  • June 2010 – The FDA approved Butrans, an extended release transdermal film that functions like a nicotine patch — that is, by being absorbed through the skin.
  • August 2012 – The FDA approved Suboxone Film.
  • July 2013 – The FDA approved sublingual tablets called Zubsolv, which were made available by September of that year.
  • November 2014 – The FDA approved Bunavail, a buccal film.
  • May 2016 – The FDA approved Probuphine, an under-the-skin implant that remains in place for six months, doling out a steady dose of the drug.
suboxone tablets
Like other drugs of abuse, Suboxone has many nicknames when sold on the street. Some of the most popular slang terms for Suboxone are:

  • Boxes
  • Bupes
  • Oranges
  • Saboxins
  • Sobos
  • Stops or stop signs
  • Subs
If an addict is switching from methadone therapy to Suboxone, they may need less Suboxone than someone who is coming directly off of opioids. The ultimate goal for everyone is to slowly taper down to an effective dose that can be used for as long as is medically necessary. Most people can reach stabilization with a daily dose of 12–16 mg of Suboxone or Subutex.
A drug half-life is the length of time it takes for half of a drug to work its way out of a person’s system. The chemical makeup of a drug and other factors — such as a person’s body weight, metabolism, how many other drugs they are taking, as well as the dosage, frequency and duration of their drug abuse — affect half-life. Buprenorphine and naloxone are the two main main ingredients in Suboxone. When taken under the tongue, such as in a Suboxone Strip, buprenorphine has a half-life of 37 hours.

When taken intravenously, buprenorphine lasts 1.2 – 7.2 hours. Naloxone has a half-life of 30 – 81 minutes in adults. Suboxone is made of four parts buprenorphine and one part naloxone. As a combination of the two, Suboxone can remain in a person’s system for up to two weeks after taking your last dose. In some cases, it may take longer to fully detox from the drug if the person is a long-time abuser or took high doses. The drug can be detected using urine and blood tests, and hair samples.

Many people wonder if you can become addicted to Suboxone. In short, the answer is yes. Suboxone is addictive, although the rates of Suboxone addiction are low compared to those of other opioids. Suboxone is blend of two drugs — buprenorphine and naloxone. As an opiate antagonist, naloxone blocks the brain’s opiate receptors, which can trigger withdrawal symptoms and even be deadly for those addicted to harder opiates like heroin. Buprenorphine is a partial opiate agonist, which activates the opioid receptors and acts like another opioid drug. The combination allows those addicted to harder opioids to wean off of their addiction without being subjected to harsh withdrawal symptoms.

The problem with using Suboxone, a partial opioid, to treat a more serious opioid addiction is the person still craves opioids and may never stop using Suboxone, thus forming an addiction. In some cases, Suboxone addicts even dissolve Suboxone Strips in water and inject the solution, bypassing the stomach and rendering the naloxone in the drug ineffective. While it is rare to become addicted to Suboxone when following a prescription and consulting with your doctor, Suboxone abuse and non-medical use is especially likely to cause addiction. Taking Suboxone intravenously is the most risky form of abuse because injection delivers faster effects and a more concentrated dose of the drug.

When you withdraw from Suboxone, symptoms are similar to those that occur when you quit other opioids.
As Suboxone has become more widely available, data shows it’s also being more widely abused. For example, in 2010, buprenorphine use led to 30,135 emergency room visits. Roughly half of these trips to the ER were following instances of abuse. Comparatively, in 2005 only a few years after the drug was released on the market, Suboxone use only led to 3,161 ER visits. When you withdraw from Suboxone, symptoms are similar to those that occur when you quit other opioids. You might experience some of the discomforts of opiate cessation, but withdrawal symptoms are significantly less severe with Suboxone. These symptoms include mood swings, muscle aches, fever, headaches, insomnia and nausea.
To an average Suboxone user, no, the drug does not get you high. However, those who abuse the medication may experience a high from it. Suboxone is a partial opiate agonist, meaning the drug does interact with the opioid receptors in the brain and can cause the euphoric feeling characteristic of opioid abuse. However, Suboxone also contains an opioid antagonist, naloxone, that prevents the brain’s opioid receptors from being triggered. The result is a drug that meets an opioid addict’s craving enough to prevent withdrawal symptoms, but does not get a person high. In fact, the medication is so powerful it blocks the user from getting high on any opiate while they take Suboxone.

Some who use Suboxone to wean themselves off of harder opioids, such as heroin, may later find Suboxone does provide a high as they get accustomed to the drug. Addicts seeking this high may even go so far as to dissolve Suboxone Strips into water to inject into themselves. Taking the drug intravenous provides the most significant Suboxone high possible because this method bypasses the digestive system, which activates naloxone.

suboxone strips
Though Suboxone is intended to help people avoid overdose as they enter recovery, overdose can still occur if the drug is used incorrectly. Injection is the most dangerous administration method, but you can overdose on Suboxone strips, pills, and every other formulation if the dosage is high enough. Because everyone has a unique physical makeup and tolerance, there is no single amount of Suboxone that causes overdose.

Overdose is essentially poisoning. When an abuser takes such a high dose of Suboxone that the body cannot metabolize it fast enough, the drug essentially poisons the body and begins to cause serious adverse side effects. Some such effects include:
● Small pupils
● Blurry vision
● Drowsiness
● Dizziness
● Slowed or stopped breathing
● Blue lips or fingers
● Fainting
● Collapse
● Death

If you notice any of these overdose symptoms in yourself or a loved one, call 911 right away. Overdose is considered a medical emergency. For many who have survived overdose, the scare of death is enough to convince them to pursue drug addiction rehab. Although there is no cure for addiction, rehab is a proven treatment method. After therapy and medical attention, it is possible to live a long and healthy life free of Suboxone addiction.

On just two recorded occasions, people have died from overdosing on Suboxone alone. More than 400 other times since it reached the U.S. market, Suboxone has been considered a “primary suspect” in overdose deaths in the U.S. However, the risk of Suboxone overdose is especially high when the drug is mixed with other drugs. Some of the most dangerous combinations include:

  • Suboxone and Xanax – One 2013 study found concurrent Suboxone and benzodiazepine use increased the risk of injury during treatment. At the close of the study, the researchers recommended Suboxone patients use alternatives to address anxiety rather than benzodiazepines like Xanax.
  • Suboxone and Alcohol – Suboxone depresses respiration. When it is mixed with a depressant like alcohol, it is possible the effects could be compounded and cause overdose or death.
  • Suboxone and Methadone – Never mix these two medications. If you are using one under medical supervision, you may request to try the other. However, you need to avoid taking either medication for a 72-hour period before beginning the other.
suboxone overdose
There has been a stark increase in Suboxone abuse since the drug first hit the market. The following Suboxone abuse statistics come from a 2013 report from The Drug Abuse Warning Network:

  • More than three million Americans have received Suboxone treatment.
  • In just four years (2006–2010), buprenorphine-related emergency room visits rose by 255%, ending with 15,778 total visits.
  • During the final year of the study, more than half of all buprenorphine-related ER visits happened due to intentional abuse of the drug.
  • Also in 2010, nearly 60% of buprenorphine-related ER visits involved other drugs.
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Blum, Kenneth, et al. “Withdrawal from Buprenorphine/Naloxone and Maintenance with a Natural Dopaminergic Agonist: A Cautionary Note.” PubMed Central, National Institutes of Health, 22 Nov. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3835595/. Accessed 2 Feb. 2017.

“Buprenorphine Sublingual and Buccal (Opioid Dependence).” MedlinePlus, U.S. National Library of Medicine, 16 Sept. 2016, medlineplus.gov/druginfo/meds/a605002.html#discontinued. Accessed 2 Feb. 2017.

“Buprenorphine.” DEA Diversion Control Division, U.S. Drug Enforcement Agency, July 2013, www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf. Accessed 2 Feb. 2017.

“The DAWN Report: Emergency Department Visits Involving Buprenorphine.” Substance Abuse and Mental Health Services Administration, 29 Jan. 2013, www.samhsa.gov/data/sites/default/files/DAWN106/DAWN106/sr106-buprenorphine.htm. Accessed 2 Feb. 2017.

“Is Buprenorphine Addictive?” The National Alliance of Advocates for Buprenorphine Treatment, www.naabt.org/faq_answers.cfm?ID=33. Accessed 2 Feb. 2017.
Mental Health Daily. “How Long Does Suboxone Stay In Your System?” Mental Health Daily, mentalhealthdaily.com/2015/10/28/how-long-does-suboxone-stay-in-your-system/. Accessed 27 Feb. 2017.

National Center for Biotechnology Information. “Buprenorphine.” The PubChem Open Chemistry Database, pubchem.ncbi.nlm.nih.gov/compound/buprenorphine#section=Metabolism-Metabolites. Accessed 27 Feb. 2017.

National Center for Biotechnology Information. “Naloxone.” The PubChem Open Chemistry Database, pubchem.ncbi.nlm.nih.gov/compound/naloxone#section=Top. Accessed 27 Feb. 2017.

“Opioids.” Substance Abuse and Mental Health Services Administration, 23 Feb. 2016, www.samhsa.gov/atod/opioids. Accessed 2 Feb. 2017.

Schuman-Olivier, Z., et al. “Benzodiazepine Use During Buprenorphine Treatment for Opioid Dependence: Clinical and Safety Outcomes.” National Center for Biotechnology Information, National Institutes of Health, 1 Oct. 2013, www.ncbi.nlm.nih.gov/pubmed/23688843. Accessed 2 Feb. 2017.
Sontag, Deborah. “Addiction Treatment With a Dark Side.” The New York Times, 16 Nov. 2013, www.nytimes.com/2013/11/17/health/in-demand-in-clinics-and-on-the-street-bupe-can-be-savior-or-menace.html. Accessed 2 Feb. 2017.

“Suboxone Dosing Guide.” The National Alliance of Advocates for Buprenorphine Treatment, www.naabt.org/documents/Suboxone_Dosing_guide.pdf . Accessed 2 Feb. 2017.

“Suboxone: The New Drug Epidemic?” National Pain Report, 23 Sept. 2013, www.nationalpainreport.com/suboxone-new-drug-epidemic-8821747.html. Accessed 2 Feb. 2017.

“SUBOXONE® (Buprenorphine and Naloxone) Sublingual Film (CIII).” Suboxone.com, Indivior Inc., Dec. 2016, www.suboxone.com/content/pdfs/prescribing-information.pdf. Accessed 2 Feb. 2017.

“What Exactly is Buprenorphine?” The National Alliance of Advocates for Buprenorphine Treatment, www.naabt.org/faq_answers.cfm?ID=2 . Accessed 2 Feb. 2017.

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Suboxone Addiction was last modified: April 5th, 2017 by The Recovery Village