What is Suboxone?

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Suboxone is used to treat narcotic (opiate) addiction in patients. It contains a combination of buprenorphine and naloxone which causes relief from withdrawal symptoms.

Buprenorphine is an opioid medication which was approved for medical use in the United States in 1981 and is sometimes called a narcotic and is a semi synthetic derivative of thebaine.

Its primary uses in medicine are in the treatment of those addicted to opioids, such as heroin and oxycodone, but it may also be used to treat pain, and sometimes nausea in antiemetic intolerant individuals, most often in transdermal patch form.

Naloxone on the other hand, blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse. When given intravenously, naloxone works within two minutes, and when injected into a muscle, it works within five minutes; it may also be sprayed into the nose. The effects of naloxone last about half an hour to an hour. Multiple doses may be required, as the duration of action of most opioids is greater than that of naloxone.

Administration to opioid-dependent individuals may cause symptoms of opioid withdrawal, including restlessness, agitation, nausea, vomiting, a fast heart rate, and sweating. To prevent this, small doses every few minutes can be given until the desired effect is reached.

Suboxone Brands

When looking at suboxone there are three major brands that are most popular. These are Probuphine, ButransBelbuca and Buprenex. Below we look at each brand in detail:

Probuphine

This is possibly one of the most efficient and forward-thinking brands of Suboxone.

Probuphine implants are available only from a certified pharmacy under a special program. You must be registered in the program and understand the risks and benefits of using this medicine.

A Probuphine implant is a 1-inch rod that is inserted through a needle (under local anesthesia) into the skin of your upper arm, just inside and above the elbow. You will receive a total of 4 implants.

After the Probuphine implants are inserted, your arm will be covered with 2 bandages. Remove the top bandage after 24 hours, but leave the smaller bandage on for 3 to 5 days. Keep the area clean and dry. Apply an ice pack to the area every 2 hours during the first day, leaving the ice pack on for 40 minutes at a time.

For at least 1 week after insertion, check the incision area for warmth, redness, swelling, or other signs of infection.

You should be able to feel the Probuphine implants under your skin. Tell your doctor if you cannot feel the implants at any time while it is in place.

Probuphine implants can remain in place for up to 6 months and must be surgically removed.

You can find out more about Probuphine in our recent article this will help you become more informed before you undertake a Probuphine implant.

Butrans

Butrans are skin patches that contain a high concentration of buprenorphine and are used for around-the-clock treatment. Your dose needs may be different if you have recently used a similar opioid (narcotic) pain medicine and your body is tolerant to it.

Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips as the patch should only be used for skin. Avoid touching the sticky side of the patch. Wash your hands after applying a skin patch and do not use if it has been cut or damaged.

Apply the Butrans patch only to clean, dry skin to a flat area of the chest, back, side, or outer side of your upper arm. Use only clear water (not soap or other chemicals) to wash the skin before application. Wear the patch around the clock for 7 days. Never wear more than 1 skin patch at a time unless your doctor has told you to.

Remove and replace the Butrans patch after 7 days. Apply the new patch to a different skin area on the chest, back, side, or upper arm. After removing a skin patch: fold it in half firmly with the sticky side in, and flush the patch down the toilet or use the Patch-Disposal Unit provided with this medication. Do not place a used patch into a trash can and dispose of any unused skin patches in the same folded manner when you no longer need this medicine. Do not flush the foil pouch or patch liners; place them in a trash container out of the reach of children and pets.

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms.

You should not use Butrans if you are allergic to buprenorphine, or if you have a severe breathing problem or a bowel obstruction.

Belbuca

Belbuca buccal films are used for around-the-clock treatment of moderate to severe chronic pain that is not controlled by other medicines.

Buccal administration is where a Belbuca film is held in the buccal area (in the cheek) and the buprenorphine passes through the tissues which line the mouth and enters directly into the bloodstream.

To use a Belbuca buccal film:

  • Wet the inside of your cheek with your tongue or rinse your mouth with water to moisten the area in your mouth before you place a film;
  • Hold the buccal film with clean, dry fingers with the yellow side facing up;
  • Using a finger, place the yellow side of the buccal film against the inside of your moistened cheek. Press and hold the film in place for 5 seconds and then take your finger away;
  • the buccal film will stick to the inside of your cheek;
  • leave the buccal film in place until it has completely dissolved, usually within 30 minutes after you apply it.

While using Belbuca, you may need frequent blood tests to check your liver function.

If you need surgery, tell the surgeon ahead of time that you are using Belbuca. You may need to stop using the medicine for a short time.

Ask your doctor how to safely stop using Belbuca and do not stop using it suddenly, or you could have unpleasant withdrawal symptoms.

Buprenex

Buprenex (or Buprenorphine) is an injected opioid pain medication.

Buprenorphine is injected into a muscle or into a vein through an IV or you may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles, syringes, IV tubing, and other items used to inject the medicine.

Buprenorphine is usually given at evenly spaced intervals, up to 6 hours apart. Tell your doctor if buprenorphine does not relieve your pain within 1 hour after an injection.

Wear a medical alert tag or carry an ID card stating that you use buprenorphine. Any medical care provider who treats you should know that you are using buprenorphine. Make sure your family members know you are using buprenorphine in case they need to speak for you during an emergency.

 

How long will I be on Suboxone?

Here are 4 pieces of good advice from leading Suboxone expert, Doctor Jeffrey Junig MD PhD, to get you thinking about how long you’ll need to use Suboxone for, and when you’ll be ready (if ever) to stop using this medication.

According to the Doctor:

  1. You Should Consider Using Suboxone at Least until a Better Medication Is Developed

On Suboxone you can live a healthy and happy life while participating fully in society. Off Suboxone you are always at risk to relapse back to opiate abuse – you are safer just staying on the medication.

The neural changes of opiate addiction may not be reversible, but with medications like Suboxone, these changes can be effectively managed and you should consider using this medication at least until a superior opiate addiction drug is developed.

  1. You Should Consider Suboxone a Long Term Maintenance Medication (Not a Medication Just to Manage Withdrawal Symptoms during a Detox)

The short term use (under a month) of Suboxone almost always ends in relapse back to opiate abuse.

Suboxone works best when it is used as a long term maintenance medication, from a minimum of 6 months to a year; and ideally for much longer than that.

  1. If You Decide You Want to Stop – Make Sure You’re Ready

According to Dr. Junig, if you decide that you want or need to taper off Suboxone then wait until you are ready to do so before making your attempt. Signs of readiness to taper include:

  • Being over 30
  • Having stable employment
  • No longer seeing any friends who are using opiates
  • Having no immediate source to secure illicit opiates
  • Being in a stable relationship or feeling secure being single
  • Having completed relapse prevention work
  • Feeling comfortable taking Suboxone once a day on an automatic basis (If you still take it ‘when you need it’ or if the use of Suboxone still provokes a lot of thought or feelings, then you are probably not ready.)

Staying comfortably on a once daily dose of 8mg for several months

  1. Avoid Using Alcohol, Benzodiazepines, Marijuana and Other Drugs While on Suboxone

People on Suboxone do best when they move forward in life while taking their medication. They do this most successfully when they engage in life through getting and maintaining employment, getting educated, enjoying hobbies and interests, getting sufficient daily exercise and working to forge and sustain healthy relationships.

People who switch from opiate use to the frequent use of another mind-altering substance while on Suboxone are much less likely to make positive life progress in any of the above listed areas.

 

Health risks

Like any drugs that you take there are health risks associated with short term and long term risks. In order for drugs to be suitable for humans there cannot be any fatal or severe short term risks, however consumption of many drugs alongside alcohol can lead to death. It’s important to understand suboxone treatment before you agree to this procedure.

Short Term Risks

Suboxone acts as a depressant in the body, which means that it slows down the person rather than speeding them up, as a stimulant would do.

As with other drugs of abuse, taking too much Suboxone in the short-term can lead to unwanted effects including:

  • Sleepiness
  • Confusion
  • Nausea
  • Respiratory depression

While Suboxone is used in the treatment of addiction, the drug itself can lead to tolerance and dependence. Suddenly stopping use of Suboxone can elicit unpleasant withdrawal effects, and prove much more difficult to quit than thought.

Other side effects that may occur during a period of active use or withdrawal include:

  • – Constipation (during use)
  • Diarrhea (during withdrawal)
  • Arthralgia, or joint pain (during withdrawal)
  • Insomnia
  • Irritability
  • Jitteriness
  • Pinpoint pupils (during use)
  • Dilated pupils (during withdrawal)

In addition, partial opioid agonists like buprenorphine and, indeed, opioid antagonists like naloxone can send someone addicted to full opioid agonist substances (like heroin or oxycodone) into what is known as precipitated withdrawal—inducing the onset of the unpleasant withdrawal symptoms very rapidly, if not immediately

 

Long Term Risks

Suboxone abuse both directly and indirectly imparts some serious long-term effects that can affect both mental and physical health.

Negative health effects can include:

  • Drowsiness
  • Gastrointestinal issues like constipation, nausea and vomiting
  • Disorientation and confusion
  • Decreased pain tolerance

Negative psychological effects can include:

  • Increased incidence of depression
  • Anxiety
  • Isolation
  • Difficulty in social situations

Possible extended issues can include:

  • Failing relationships.
  • Trouble with responsibilities (e.g. parenting, work, school).
  • Financial strain.
  • Legal problems associated with addictive behaviors.

Always talk to your doctor before any change in your medication involving Suboxone.

All information in this document has been checked using the most popular, comprehensive and up-to-date source of drug information online: http://www.drugs.com.

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