Medication-assisted treatment options for opioid use disorder, particularly methadone and buprenorphine, have shown great promise in helping those in recovery manage opioid cravings and withdrawal symptoms.
MAT can help these individuals sustain longer-lasting recoveries from opioid abuse with a reduced likelihood of relapse.
However, despite being FDA approved to treat opioid use disorder and having relatively low abuse potentials, buprenorphine-based medications like Suboxone can still be misused and may promote the development of dependence and addiction in some circumstances.
Suboxone is a brand-name prescription medication made with a combination of buprenorphine (a long-acting synthetic opioid-like medication) and naloxone (an opioid antagonist).
Generic equivalents are also available. These medications are prescribed exclusively to treat opioid addiction and are available as both sublingual films and tablets that dissolve in the mouth.
How Buprenorphine & Naloxone Work
Inside the body, buprenorphine binds to opioid receptors in the central nervous system, stimulating the same pleasurable pathways as other opioid drugs like oxycodone, hydrocodone, morphine, fentanyl, heroin, and others.
However, buprenorphine is only considered to be a partial opioid-agonist, meaning that it only activates opioid receptors weakly while also helping to block the effects of opioid drugs while it is active in the body.
The naloxone portion of the drug is included to prevent Suboxone from being snorted or injected, reducing its potential for misuse.
While it is still possible for a person to take more Suboxone than prescribed, the drug is known for having a ceiling effect that self-limits its euphoria and other effects after a fairly low dosage.
Suboxone’s Potential For Abuse
Due to these factors, Suboxone is considered to have only a moderate to low potential for abuse and is classified as a Schedule III controlled substance, compared to the Schedule II and I classifications awarded to most other opioids.
Nevertheless, cases have been reported where some people who were not opioid-dependent misused Suboxone, enjoyed its long-lasting pleasurable effects, and eventually became addicted to the drug.
Notably, those who have not already developed tolerance towards opioids tend to experience the drug’s effects more strongly.
In fact, the potential for someone recovering from a less-potent opioid-related substance use disorder to abuse Suboxone has actually been found to be greater than that for someone who previously abused ‘harder’ drugs like heroin or fentanyl.
Other studies have shown that those most likely to misuse Suboxone are those who wish to self-treat opioid withdrawal symptoms outside the medical system.
The drug may also sometimes be misused by those looking for another option for chronic pain relief, or those who suffer from anxiety or other mental health issues.
Warning Signs Of Suboxone Abuse
In an addiction treatment setting, healthcare providers will carefully time the first dose of Suboxone to avoid triggering acute opioid withdrawal symptoms, as both components of Suboxone are known for displacing other opioids from opiate receptors inside the body.
This means that sudden onset of opioid withdrawal symptoms can be a sign that a person has recently been abusing opioids and then switched to Suboxone abuse.
Other potential signs and symptoms of Suboxone abuse can include:
- experiencing side effects of Suboxone, commonly including dizziness or blurred vision, drowsiness, sedation headache, back pain, tongue pain, numbness, tingling, sweating, nausea, vomiting, constipation, and insomnia
- running out of one’s regular Suboxone prescription early
- drug-seeking behavior like doctor shopping, asking others to use their medication, theft, or attempting to
- purchase the drug online or on the street
- changes in mood, behavior, mental health, hygiene, and self-care
- loss of interest in work, school, hobbies, responsibilities, and relationships
- experiencing illness, cravings, mood changes, and other symptoms of buprenorphine withdrawal when the drug is unavailable
- experiencing a Suboxone overdose, which (similar to other forms of opioid overdose) can include respiratory depression, sedation, confusion, low body temperature, changes in pupil size, coma, and (usually in combination with other CNS depressants) death
Treating Suboxone Addiction
While Suboxone addiction is fairly uncommon, it can be treated using the same proven strategies and services that have been developed to help address many other forms of drug addiction.
A personalized Suboxone treatment plan may include:
- tapering/medical detox services to help a participant safely progress through the process of Suboxone withdrawal
- outpatient treatment services with an emphasis on individual and group counseling and other forms of therapy
- inpatient treatment services for intensive and regimented care that may include behavioral therapy, peer support, dual diagnosis treatment for co-occurring mental health disorders, and alternative therapy options
- aftercare support which may include case management, employment counseling, participation in support groups, and more
To learn about our inpatient opioid addiction treatment options, please contact us today.
- Drug Enforcement Administration (DEA) https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf
- Food and Drug Administration (FDA) https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/022410s042lbl.pdf
- Journal of Addiction Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177012/
- National Library of Medicine: MedlinePlus https://medlineplus.gov/druginfo/meds/a605002.html