Many called it a “wonder drug” when it received FDA approval in 2002—a panacea for the nearly 2.1 million people suffering from opioid dependence in the United States. Suboxone quickly became the preferred treatment medication for those looking to avoid the torment of opioid withdrawal, generating more than $1.5 billion in U.S. sales every year.
So, What is Suboxone and how is it abused now? For many, however, the drug remains an enigma. Is it the “savior” in the opioid epidemic many doctors and addicts claim it to be? Or is it simply a crutch with potentially greater risks than the drugs it replaces? Here is everything you need to know about it.
Suboxone is the brand name for a medication used to treat those addicted to opioids—be it heroin, fentanyl, or prescription pain relievers like OxyContin or Vicodin—by reducing the symptoms of withdrawal. It contains two key ingredients: buprenorphine and naloxone.
Buprenorphine is a partial opioid agonist, meaning it blocks opiate receptors in the brain and reduces cravings. Naloxone binds to receptors and helps reverse the effects of opioids. In other words, it is like taking an opioid without the intense high and euphoria that addicts crave.
According to Dr. Adam Bisaga, professor of psychiatry at CUMC and researcher at New York State Psychiatric Institute, “When taken properly, individuals on Suboxone will have no cravings, have no withdrawal, and will feel ‘normal’…that’s why it’s so effective.”
So how does one become addicted to opioids in the first place and how does Suboxone come into play? Basically, the presence of an opioid drug in the brain causes a flood of the neurotransmitter dopamine, a chemical messenger responsible for mood regulation, feelings of pleasure, anxiety minimization, and enhanced relaxation. These sensations result in a feeling of euphoria for the user, a feeling addicts chase each time they use.
If abused and taken regularly over a long period of time, opioids can permanently alter brain chemistry, resulting in physical dependence on the drug and severe withdrawal if abruptly removed from the body.
The symptoms of withdrawal for those addicted to opioids are often s and potentially dangerous. These symptoms include muscle pain, restlessness, sweating, extreme anxiety, insomnia, and even tremors.
Suboxone alleviates or eliminates these symptoms if taken properly and part of a comprehensive treatment program. It is essentially a long-acting opioid that stays in the bloodstream longer than most other opiates, so it can be given in lower doses less often to minimize withdrawal symptoms. The ingredient buprenorphine also contains a “celling effect,” meaning it limits any pleasurable feeling the user can experience, thereby curtailing its potential for abuse.
Doctors typically begin tapering down doses of Suboxone—which typically come in sublingual strips that are dissolved under the tongue—until the medication is no longer needed.
Suboxone is a depressant, meaning it lowers neurotransmission levels in the brain to reduce arousal or stimulation. Short-term effects can include headaches, slowed pulse, slowed breathing, sluggishness, dilated pupils, slurred speech, nausea, sweating, constipation, and dizziness, among others.
Although Suboxone is intended to help addicts overcome opioid withdrawal, it nonetheless possesses its own risks for abuse and addiction. Keep in mind, it is still a partial opiate agonist, meaning it interacts with opioid receptors in the brain similar to any other narcotic. It is a Schedule III Controlled Substance—in the same category as codeine, ketamine, and anabolic steroids—meaning it may lead to moderate or low physical dependence or high psychological dependence.
Data also indicates that the increasing availability of Suboxone led to higher cases of abuse. Emergency room visits related to Suboxone abuse increased by 255 percent in just a four-year span. Intentional abuse of the drug accounts for more than half of all emergency room visits.
Addicts who abuse Suboxone often do so by taking more than the recommended dose or by failing to properly taper off the drug, leading to withdrawal and the potential for long-term addiction. Withdrawal symptoms for Suboxone are similar to other opioids.
It is also possible to overdose on Suboxone. Some addicts mix sublingual strips with water and inject the drug directly into the bloodstream, leading to the most common form of overdose. However, an overdose is possible with any means of ingestion if taken in high enough doses. Symptoms of Suboxone overdose include small pupils, blurry vision, dizziness, fainting, slowed breathing, or even death.
If you or a loved one struggles with Suboxone addiction, help services are readily available. These include detox and drug rehabilitation centers, as well as therapy and medical attention.