Using Suboxone as a Medication Assisted TreatmentThe road to recovery from opioid addiction can be a difficult one. Withdrawal is a physically and mentally challenging process to put the body through. Thanks to treatment programs that use Suboxone as Medication Assisted Treatment (MAT), it's getting easier to find sobriety and maintain it without the unpleasant symptoms.
At the Virginia Center for Addiction Medicine, we use Suboxone as a component of effective MAT programs to make sobriety easier to achieve and hold onto. Through a long-term Suboxone regimen, addicts can make progress towards their personal goals. The medication helps to reduce mental and physical symptoms of withdrawal so that recovery can be slow, steady, and lasting.
Our MAT programs were created with people in recovery in mind. By removing the distracting and unpleasant side effects that come along with withdrawal, patients can make more progress and remain sober even after treatment is over.
What is Suboxone?Suboxone is the brand name of a medication approved for clinical opioid use disorder treatment. This oral medication will block the effects of other opioids. This is because the drug is powered by buprenorphine and naloxone.
Buprenorphine is a partial agonist and will block the effects of other narcotics. It works by blocking the opiate receptors and reducing the individual's urges. This is the ingredient that helps to mimic the effects of opioids in the body. 
Naloxone, the other main active ingredient, is an opioid antagonist that can reverse an opioid overdose. This ingredient fights the effects of continual opioid abuse. Together, these two active ingredients create a safe and effective opioid abuse treatment. 
Unlike other opioid abuse treatment medications, Suboxone can be prescribed by your doctor. It doesn't have to come from a specialized addiction treatment center. While Suboxone alone is excellent to manage withdrawal symptoms, it won't lead to recovery without a comprehensive treatment program also.
Suboxone has two different uses. It can serve either as a detox method or as a component of our medication assisted treatment.
Suboxone as a Detox Method vs Medication Assisted TreatmentThere are a few significant differences between using Suboxone as a detox method and using it as a part of medication assisted treatment.
As a detox method, Suboxone's main ingredient, buprenorphine, comes in to trick your body into believing it's getting the opioids it craves. This will lessen the "cold turkey" withdrawal symptoms and make it easier for addicts to make it through this tough first phase of recovery. When used in this way, the Suboxone is only a short-term solution beginning when mild withdrawal symptoms start to show and used for about 13 days after that.
The National Institute for Drug abuse has conducted recent clinical studies. These show that patients using buprenorphine over a 13-day taper program were more likely to complete the program with opioid-negative urine samples than those who used another detox drug, clonidine. 
Using Suboxone as a component of a medication assisted treatment, on the other hand, is a more "whole patient" approach. It utilizes small, regular tapered doses of Suboxone to provide the mental and emotional stability needed for gradual, lasting recovery.
The MAT approach involves longer-term use of Suboxone. Before the MAT process gets started, initial consultation and exam will help to determine what your MAT program will consist of. By providing hair or urine samples and reporting your drug use habits, the doctor will be able to create a tailored regiment specific to you. It may include components of physical therapy, counselling, or psychiatric evaluation.
Once that is all set up, you'll begin the induction portion of treatment. This is during the first three days. You must stop using opioids for at least 16 hours before the induction office appointment. This short period of abstinence can take place under medical supervision or at home until you reach a moderate state of withdrawal.
Once the induction dose is given, you'll feel relief within an hour. During this phase, you will need to come in for follow-up visits so the doctor can monitor progress. They also may adjust doses to find the right balance. You can help your provider with this portion by sharing about how you are feeling.
The second phase of Medication Assisted Treatment with Suboxone is called Stabilization. During this time, you will regulate your medication to a dose that works best for you. You will also begin to work towards your overall treatment goals. These are achieved via counselling programs and other supplementary treatments. As treatment goals are reached, and progress has been made, your doctor may begin decreasing the dosage as you transition into the third and final phase. Decreasing dosage and frequency is completely based on the individual patient’s recovery progress, we take an individualized approach for patient care.
The final phase is called Maintenance. There is no determined timeline for how long Maintenance will last. It can continue as long as necessary. There is research that supports at least one year of treatment.  The length of treatment will depend on your progress in reaching your recovery goals.
How Long Should I Take Suboxone?Medical professionals vary in their theories about how long a patient should use Suboxone while on a Medication Assisted Treatment program. While some people think Suboxone should only be taken for a short time during detox, no evidence supports that claim. Just as a person with diabetes uses insulin long-term to help manage their diabetes, a person in recovery can find great support in using Suboxone to manage their addiction within an MAT program. 
Patients who stop using Suboxone soon after the detoxification process should be aware that there is a higher risk of relapse. Studies show that patients have a higher risk of relapse when cutting off their buprenorphine maintenance in less than six months. 
For this reason, it's best to consult with your prescribing physician about how long your maintenance program will continue and work to develop your recovery outside of your medicine.
Benefits of Using Suboxone as a Medication Assisted TreatmentSome people refuse to quit because of their fear of detox and withdrawal. Medication assisted treatment is a good alternative since it removes the fear of withdrawal symptoms with its steady, controlled opioid doses. The benefits of using Suboxone as medication assisted treatment don't stop there, though. Additional advantages include:
- It allows for recovery without requiring full detoxification
- It helps people that won't quit because of their fear of detox.
- It allows people who are addicted to continue getting smaller and smaller regulated doses of their opioids. This helps to get more people off the streets and into a healthy lifestyle. Instead of feeling like they need to run around town to get their fix, the clinical doses in their system will keep their cravings at bay.
- It treats the whole patient and the underlying causes of addiction rather than treating detox symptoms.
- It decreases opioid use, overdoses, crime, and transmission of infectious disease.
- It increases social functioning and retention during treatment. Those in therapy, along with medication, are more likely to remain committed. This is in comparison to - those who don't have medicine.
- It improves the outcome for the babies of pregnant women who are opioid-dependent. 
Another benefit the MAT option provides over a detox option is the opioid blocker within the medication. This means that even if they decide to go rogue and use opioids or heroin again, it is much harder for them to overdose.
Suboxone in Conjunction with TherapyDuring medication-assisted treatment, patients will find it easier to get through the initial withdrawal period and remain clean from addictive substances. It helps to alleviate the unpleasant physical side effects of detox. To treat the core of the addiction, however, therapy is often needed.
Therapy will help you to explore your cause of addiction and treat the triggers that bring addictive compulsions back up. This can be done through either individual or group therapy programs.
Individual TherapyThere are many benefits to attending individual therapy during a MAT program. Addiction doesn't often come along on its own. There are usually underlying issues or past trauma that contribute to addiction development. Individual counselling, along with medication treatment, can improve your recovery. The benefits of one-on-one therapy for opioid abuse include:
- Identification of past turmoil or trauma that affected you and your addiction
- Creating new perspectives about your addiction
- Developing new habits and healthy coping mechanisms to deal with triggers or stress
- Better mental processing in times of failure or victory
- Creating exit strategies that allow you to get out of dangerous or triggering situations
- Establishing and reaching personal goals
Through methods like cognitive behavioural therapy, motivational interviewing, and mindfulness-based stress reduction (MBSR), psychologists can play a significant role in helping with opioid use disorder. 
Group TherapyAttending therapy with a group of other recovering opioid addicts can also be beneficial to the recovery process in different ways. In addition to being surrounded and supported by individuals who understand what you're going through, it can also help to create new perspectives as you heal. The benefits of including group therapy in addition to medication assisted treatment program are:
-Positive peer support to encourage abstinence from addictive substances
- Reducing the sense of isolation that can follow the recovery
- Ability to witness the rehabilitation of other addicts for motivation
- Developing new coping mechanisms by seeing how others deal with similar issues
- A family-like experience of support
- Ability to provide relevant feedback to others
- Encouragement as new obstacles and challenges come up
- Opportunity to re-learn healthy social skills with like-minded individuals
- Includes structure and discipline that can aid in recovery
- Support can spill over outside of the sessions
Suboxone As a Component of a Successful Recovery Pathway - Not the "Silver Bullet" for Opioid AddictionUsing Suboxone or another similar medication as a component of recovery can make it easier to help an individual break their addiction cycle. While most addicts looking to transition into a sober life aren't too excited about the idea of the Suboxone detox process, the option to wean off their drug of choice over an extended period sounds much more manageable.
The idea is not to trade one illicit drug addition out for prescription drug addiction. Instead, the buprenorphine prescribed is monitored by medical professionals. Of course, anyone who maintains a regular buprenorphine regimen can become physically dependent. If they are taken off the medication suddenly, they will experience withdrawal symptoms. The idea of MAT is to avoid that often-risky withdrawal period by allowing them a small amount of the medication over time while they work in other ways to build and prepare for a healthy life.
Hopefully, buprenorphine is not something that everyone will stay on forever. It can be used as a temporary or lifelong form of support in conjunction with other treatment methods. The idea is that by taking a steady dose people can begin to rebuild their lives.
By using the extra time and physical support the medication allows, the patient can build themselves up to recovery over time. When used the right way, with careful medical assistance, it can be a much smoother transition into sober living.
It's important to realize that this is by no means a cure to an opioid addiction disorder. It is merely a step in the right direction. While the medication component will help to alleviate the physical and mentally gruelling side effects of withdrawal and detox, it will not aid in recovery unless you are motivated and dedicated to recovery. You must put in the work within therapy or alternative, complementary treatment options to create lasting change that will support you through sober living.
When MAT is combined with a counselling program, it can become much easier to get past the obstacles along the road to recovery. The medication alleviates the physical pain and mental instability that withdrawal causes so that each individual can give their best effort to heal inner trauma, avoiding triggers, and create coping mechanisms that will support lifelong sobriety.
Contact UsAfter the opioid detox process is over, relapse is still a real possibility. Using Suboxone as a part of a medication assisted treatment (MAT) program plays a significant role in the long-term sobriety of anyone who is looking to recover. At the Virginia Center for Addiction Medicine, our trained physicians and team will combine behavioural treatments with effective medication to make lasting recovery possible for anyone.
Don't go through the recovery process alone. The Virginia Center for Addiction Medicine is here to help.
If you need any more information about the process of want to talk to an expert, get in contact with our team at 804.332.5950.
ResourcesMedically Reviewed Suboxone Facts: https://www.addictioncenter.com/treatment/medications/suboxone/
American Society of Addiction Medicine - MAT Program Overview: https://www.asam.org/docs/default-source/education-docs/mat-program-overview_2-12-2019239e2b9472bc604ca5b7ff000030b21a.pdf?sfvrsn=93224bc2_0
Suboxone Website: https://www.suboxone.com/treatment/
Short Term Opioid Withdrawal with Buprenorphine Fact Sheet: https://www.drugabuse.gov/sites/default/files/files/BupDetox_Factsheet.pdf
Pew Research Data: https://www.pewtrusts.org/~/media/assets/2016/11/medicationassistedtreatment_v3.pdf
Substance Abuse and Mental health Services Administration on Buprenorphine Use to Treat Opioid Addiction: https://www.naabt.org/documents/TIP40.pdf
Effective Treatments for Opioid Addiction: https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction/effective-treatments-opioid-addiction
UCLA Substance Abuse Publication: https://www.ncbi.nlm.nih.gov/pubmed/23222095
American Psychological Association Opioid Abuse Treatment: https://www.apa.org/helpcenter/opioid-abuse
Substance Abuse Treatment: Group Therapy: https://www.ncbi.nlm.nih.gov/books/NBK64223/