Suboxone is a drug that is often used for the treatment of opioid addiction. Physicians often prescribe this medication to help those that have been struggling with opioid addiction. This could be illicit drugs like heroin and even over-the-counter drugs like tramadol and so on. However, people do buy this over- the counter-drugs, even when they don’t have any medical condition. They buy it just to get high off it. This is why Suboxone is given, to help people that can’t do without the drug.
However, just like other medications, and opioids, in particular, they all have side effects. Opioids do have withdrawal symptoms, especially when the individual stops using the drug abruptly, and without the guidance of a doctor. You should visit a Suboxone clinic if you know you have an addiction to opioids for proper guidance. Apart from withdrawal symptoms, Suboxone also has some side effects, especially when abused or used in excessive amounts. Before going into the side effects and withdrawal symptoms of Suboxone. It’s important to know about the Suboxone and what it’s used for. Suboxone is composed of two major things. These are buprenorphine and naloxone. These drugs are combined together so that the drug can be effective for the long-term treatment of opioid addiction.
What Is Buprenorphine?
Buprenorphine is an opioid medication that is used for the treatment of opioid addiction. Apart from treating opioid addiction, it’s also used for other diseases like acute and chronic pain. This drug can be used through different routes. They can be used sublingually, by injection, skin patch, or even as an implant. It’s important to be guided by a physician when using this drug. However, for the long-term treatment of opioid addiction, the medication is used in combination with another drug, naloxone. The effect of buprenorphine starts showing within one hour and can last for up to a full day. Buprenorphine has some side effects, some of which include respiratory depression, QT prolongation, adrenal insufficiency, hypotension, allergic reactions, and addiction, seizures, especially among those who have a history of seizures in the past. Patients might present with opioid withdrawal signs and symptoms if they stop using the drug suddenly, however, they are usually mild. Some drug abusers use this drug just to get high off it, others also use it in place of heroin to get a similar feeling.
What Are the Medical Uses Of Suboxone?
- Opioid addiction: This medication is used primarily for the treatment of opioid addiction. It should be given to patients, immediately when they start presenting with signs and symptoms of opioid withdrawal. However, the drug should be used in combination with naloxone, for a longer treatment of addiction. A new dosage has been approved in the United States, where you only have to take an injection a month.
- Buprenorphine versus methadone: Although Buprenorphine and methadone have a similar mechanism of action, and also have similar adverse effects. Buprenorphine usually shows less respiratory depression in cases of abuse as compared to methadone.
- Used in the process of patient rehabilitation and detoxification: Rehabilitation programs do consist of two phases. These are the detox and the treatment phases. In the detoxification phase, the patient is supervised by health care workers, to help the patient with the withdrawal from the drugs od dependency onto other drugs like suboxone and buprenorphine and so on. The drugs can also be combined with other drugs like benzodiazepines. The purpose of using benzodiazepines with the drug is to help calm the patient down, relax the muscles, help with sleep and anxiety. In addition, clonidine, an anti-hypertensive drug is also used to improve the signs and symptoms of withdrawal. Lastly, other drugs that are used include anti-inflammatory medications, such as aspirin and ibuprofen. The treatment phase starts when the patient is stable and has been given a medical clearance. The treatment phase comprises of therapy sessions, group and individual counseling with health care workers, such as counselors, psychologists, psychiatrists, social workers and so on.
- For the treatment of pain: Buprenorphine can be used in the form of a transdermal patch. This is mostly used for the treatment of chronic pain. Patches are not ideal for use in cases like acute pain, or post-surgical pain. They are also not recommended for opioid addiction.
What Are The Side Effects Of Buprenorphine?
Buprenorphine has some adverse effects. However, the severe side effects occur when the drug is abused. Most of the common side effects of Buprenorphine are just like that of any opioid. They include nausea, vomiting, headache, loss of memory, dizziness, confusion, drowsiness, dry mouth, constriction of the eye pupils, reduced libido, especially in men, urinary problems, perspiration and so on. Other adverse effects of this drug include central nervous system disorders and constipation. However, these are not as common as the symptoms mentioned earlier.
- Respiratory effects: Respiratory depression is one of the most severe side effects of buprenorphine. It happens in patients that use a combination of benzodiazepines, alcohol and with an underlying pulmonary disease. Naloxone wouldn’t be entirely effective when used for the treatment of this condition. Patients might have to be placed on the additional support, so they can breathe well. Buprenorphine tends to have fewer cases of respiratory depression, especially in when used for the treatment of chronic pain management; however, it does have the same effects like other opioids when used in an acute pain management setting. However, buprenorphine usually causes a less respiratory side effect as compared to Methadone.
- Dependence: This drug has a huge risk of dependence. Patients might become physically and mentally dependent on this drug, as it has a long half-life. The half-life of buprenorphine has been put at a day to about 3 days. This is why close supervision is a need for patients that are on this drug. Patients could be switched to a drug combination of buprenorphine and naloxone, or gradually taken off the drug, under the guidance of a physician.
What Is Naloxone?
Naloxone is a medication that is used to counter the effects of opioids, especially in cases of overdose. Naloxone also has to be combined with an opioid drug to reduce the risk of abuse and misuse. Naloxone starts working within two minutes after it’s administered intravenously, and five minutes when it’s injected into a muscle. It can also be used through the nose, although this would take around about thirty minutes to an hour before it starts working, giving opioid to people already dependent on opioids may lead to signs and symptoms such as include tachycardia, opioid withdrawal, nausea, vomiting, anxiety, agitation, and profuse sweating. The drug should be given in small doses until the desired effect is achieved. In addition, those with a history of heart diseases have been reported to have problems after taking naloxone. This is why it’s important to speak to your doctor before using the medication. Naloxone is considered safe for use in pregnancy. The drug works by reversing the depression of the central nervous system and the respiratory system caused by opioids.
What Are The Medical Uses Of Naloxone?
- Opioid overdose: Naloxone is useful for the treatment of opioid overdose. It can be used for acute and chronic cases. It’s usually used in combination with buprenorphine for the treatment of long-term opioid addiction. It’s also part of the response kits for heroin users and other opioid drug users. Naloxone should be prescribed with an education of how to use the drug, what to do in case of an overdose, and how to prevent overdosing on the drug.
- Preventing the abuse of opioid drugs: Naloxone is usually administered with other oral opioid drugs, such as buprenorphine when taken through the oral route. This is because naloxone is usually not well absorbed when taken through the oral route. Another reason why it’s used in combination with other drugs is to prevent abuse. In some countries, the drug is sold with another drug as a fixed combination. An example is Germany.
- Shock: Patients who are in shock, be it septic, hemorrhagic or cardiogenic and was given naloxone had a better blood circulation as compared with those who didn’t take naloxone.
- Clonidine overdose: Naloxone is also important for the treatment of clonidine overdose. Clonidine is an antihypertensive.
- Itchiness: Naloxone is also important for the treatment of opioid use complications such as itchiness.
What Are The Routes Of Administration Of Naloxone?
- Intravenous: This is the fastest of administering naloxone. The medication starts working within a minute and can last up to 45 minutes.
- Intramuscular: Naloxone can also be administered through the muscles. Other routes of administering the medication include nasal spray, and through injections.
What Are The Adverse Effects Of Naloxone?
This drug has little to no side effects. However, this drug might trigger some reactions especially in people that have opioid drugs in their system. Some of the symptoms that patient might present with include sweating, anxiety, vomiting, nausea, headache, arrhythmia, pulmonary edema, and seizures. Naloxone has no other side effects, aside from the ones listed above.
What You Should Know About Suboxone
Suboxone has its own risks, adverse effects, and withdrawal symptoms, especially when abused. In fact, switching to this after abusing another opioid is just like jumping from frying pan to fire. Although the effects are usually milder, they are still very much unpleasant. As earlier said, suboxone is a drug that contains buprenorphine, a partial opioid agonist, and naloxone. Naloxone is an opioid antagonist. It blocks the opioid receptors, thereby protecting the body from the effects of opioid drugs, especially after an overdose. The two drugs are combined to discourage users from overdosing or abusing the drug.
What Are The Side Effects Of Suboxone?
- It causes sleepiness: The patient would sleep more than normal, reducing the general productivity of the patient. However, it can also lead to insomnia.
- It can cause confusion
- It can also cause nausea and vomiting.
- It can cause the depression of the respiratory system.
- Withdrawal symptoms: Stopping the use of suboxone abruptly can lead to the development of withdrawal symptoms. These symptoms are unpleasant. Below are some of the symptoms that patients might present with;
- Diarrhoea and constipation: Patients might present with diarrhea when he/she stops taking the medication abruptly. This is why it’s important to stop the gradually, and with the guidance of a physician. On the other hand, the drug can also lead to constipation. However, this occurs when the patient is still using the drug.
- Pain in the bones and joints: This occurs mostly during withdrawal. The patient might feel pain in the joints, and also in the bones.
- Lack of sleep: Patients might start having sleeping problems during withdrawal periods. This condition is also referred to as insomnia.
- Constriction of the pupils: This occurs during the use of the medication. Patients might experience a pinpoint pupil
- Dilated pupils: This occurs during withdrawal. Patients would present with dilated pupils.
- Painful urination: Patients might experience pain when urinating.
Withdrawal Symptoms of Suboxone
In addition to the above adverse effects, suboxone can also cause withdrawal symptoms. This occurs when has been taking the drug for a long time, then stops using it abruptly for some reasons. Patients will start presenting with withdrawal symptoms when this occurs. These symptoms are similar to that caused by other opiate drugs. The severity of the symptoms depends on the duration of the use of the drug before the patient stopped. Some of the common withdrawal symptoms include;
- Abdominal pain
- Anxiety and confusion
- Insomnia and sleepiness
- Mood swings
- Excessive sweating
Patients affected by withdrawal symptoms can also suffer mental disorders like depression. This is because withdrawal can be too much for them to bear, leading to abuse and dependence on the drug. There have been a lot of discussions about the safety of suboxone. However, the truth is the drug has helped thousands of addicts, although people should be given some education before administering the drug to them.
Cell Surgical Network (certified in mini-liposuction harvesting and deployment)
DC, Maryland, Virginia Pain Society (active member in good standing) Suboxone Clinic in DC
Dethmers, M. (2010). Ambulante opiatendetox met Suboxone®. Verslaving, 6(2), pp.50-54.
HUNTER, W. (2007). Suboxone for Opiate Withdrawal in the Hospital. Clinical Psychiatry News, 35(1), p.54.
Platt, A. (2014). Suboxone: A Harm Reduction Approach. Journal of Alcoholism & Drug Dependence, 02(05).
Sander, G. (2007). Suboxone® im Alltag – Erste Erfahrungen. Suchttherapie, 8(4), pp.162-163.