SUBOXONE® Addiction Treatment in Illinois

During medical detoxification and medication-assisted addiction treatment programs, certain drugs are used to alleviate the detrimental withdrawal symptoms, help achieve abstinence, and maintain recovery.

SUBOXONE® is one of the medications commonly used in addiction treatment plans for opioid drug use.

Our guide below offers everything you need to know about this SUBOXONE®, from its components and how they work to its side effects and usage protocols.

What Is SUBOXONE®?

SUBOXONE® is an FDA-approved drug for use as MOUD (Medications for Opioid Use Disorder). It’s a Schedule III prescription medication that consists of two compounds: buprenorphine and naloxone.

Besides its use for substance use, it’s sometimes used off-label as a pain medication.

What Are the Forms of SUBOXONE®?

As SUBOXONE® is made for use by patients struggling with addiction during their recovery process, it was formulated to be easy to administer/take.

SUBOXONE® is available in two forms; a sublingual film and a tablet. Both these forms are designed to dissolve in the mouth, so they essentially produce the same results.

However, some patients prefer SUBOXONE® films because they allow them more flexibility in decreasing the dose since they can be taken in smaller increments as they progress toward full recovery, especially when their supervised treatment plan reaches the stage of stopping SUBOXONE®.

Other patients opt for SUBOXONE® tablets not just because they’re more affordable, but also somewhat more discreet.

Besides these two forms, SUBOXONE® comes in multiple strengths to suit different addiction cases and recovery phases. These typically include;

• 12 mg buprenorphine and 3 mg naloxone.
• 8 mg buprenorphine and 2 mg naloxone.
• 4 mg buprenorphine and 1 mg naloxone.
• 2 mg buprenorphine and 0.5 mg naloxone.

What Is the Mechanism of Action of SUBOXONE®?

SUBOXONE®’s mechanism of action involves the joint buprenorphine/naloxone effects.

Buprenorphine is a partial opioid agonist, meaning that it’s an opioid compound that produces effects similar to opioid drugs, but less intense.

The lower potency enables healthcare providers to use buprenorphine to ease withdrawal symptoms with a medication that gives the patient similar yet weaker sensations as the illicit drug. This makes the process of weaning off the full opioid a lot easier.

Additionally, buprenorphine has a low potential for misuse and overdose thanks to the upper limit of its impact. This means that its opioid effects have a maximum intensity that doesn’t increase with larger doses.

What’s more, because buprenorphine has a high receptor affinity, it may prevent other opioid compounds from attaching to opioid receptors in the CNS (central nervous system). In other words, it can keep the patient from further abuse of opioid drugs.

Naloxone, on the other hand, is an opioid antagonist. This compound is already available on its own in medications meant for rapidly reversing fatal opioid overdose effects.

However, when it’s used alongside buprenorphine, it’s intended to block attempts of misusing buprenorphine for its opioid effects.

Even if it’s weaker than illicit opioid drugs, some people will try to misuse buprenorphine by inhaling it as a powder or injecting it after dissolving.

What Are the Benefits of Using SUBOXONE® in Addiction Treatment?

SUBOXONE® is one of the most vital tools for alleviating opioid withdrawal symptoms.

It offers certain advantages for treatment, including a lower risk of misuse and higher overdose safety. This enables health professionals to rely on this medication for long-term treatment.

Additionally, SUBOXONE® manifests long-acting effects that allow for prescribing it every other day instead of daily.

SUBOXONE® vs Methadone

Both SUBOXONE® and methadone are medications used in the treatment of opioid addiction, however, SUBOXONE® is the more recent prescription out of the two (early 2000s vs 1940s-1950s).

Compared to methadone, SUBOXONE® was more specifically formulated to aid in alleviating opioid addiction. As such, it was formulated with a significantly lower risk of developing dependency.

Additionally, SUBOXONE® was engineered to have less severe and shorter-lived side effects that impact the body rather than the mind.

Are There Side Effects or Risks to Using SUBOXONE® in Addiction Treatment?

Yes, taking SUBOXONE® can result in side effects ranging from mild to severe.

Common Side Effects

Some of the more common SUBOXONE® adverse effects include;

• Sweating
• Headache
• Nausea
• Vomiting
• Numbness, redness, and burning sensation in the mouth or tongue
• constipation
• Insomnia
• Anxiety
• Depression
• Back pain
• Muscle weakness or fatigue
• Increased heart rate, abdominal cramps, and other opioid withdrawal symptoms

The side effects of SUBOXONE® may last between a few days to a couple of weeks. If they persist longer than that or get worse, patients should seek medical help as soon as possible.

Less Common Serious Side Effects

While SUBOXONE® can cause more severe side effects, they aren’t a common occurrence. Serious SUBOXONE® adverse effects include;

• Problems in breathing
• Hormonal issues, mostly adrenal complications
• Misuse
• Liver damage
• Dental complications such as tooth decay and cavities
• Extreme allergic reactions, such as skin rashes, trouble breathing, or swelling of the throat
• Low blood pressure upon standing up
• Coma

Dependence

Long-term use of SUBOXONE® can cause patients to develop psychological and physical dependence, leading to cravings that may result in drug abuse.

SUBOXONE® dependence can trigger serious side effects and cause potentially fatal overdose.

Withdrawal

Because SUBOXONE® can cause psychological and physical dependence when used long-term, stopping it suddenly can result in withdrawal symptoms such as;

• Headache
• Nause
• Muscle aches
• Diarrhea
• Insomnia
• Agitation
• Sweating
• Anxiety
• Cravings

Overdose

Patients who take SUBOXONE® can overdose if they take too much of the medication at once as this increases the risk and severity of the associated side effects. Overdosing is even more likely if they abuse SUBOXONE® while consuming alcohol and benzodiazepines.

Symptoms of SUBOXONE® overdose include;

• Pinpoint pupils
• Nausea and vomiting
• Abdominal pain
• Diarrhea
• Severe headache
• Burning sensation of the tongue or mouth
• Low blood pressure
• Low blood sugar level
• Dizziness
• Anxiety
• Chills and tremors
• Sweating
• Fatigue
• Lowered sensitivity to touch
• Sedation
• Difficulty breathing
• Decrease in respiratory rate
• Coma
• Death

How Is SUBOXONE® Used in Addiction Treatment?

Now, let’s take a look at the general guidelines for using SUBOXONE® for opioid addiction treatment:

Dosage

The appropriate dosage of SUBOXONE® is to be determined only by a specialized doctor who’ll consider several factors before prescribing, including:

• The type of opioid addiction
• The severity of the addiction
• Whether the patient is already on treatment, and if so, what stage
• Medical conditions the patient may be suffering from

That said, treatment using SUBOXONE® will most likely start with a low dose then an assessment of the effect of that dose followed by a dose adjustment until we reach the smallest possible dose that produces satisfactory effects.

SUBOXONE® dosage for treating opioid dependence is divided into two stages – induction and maintenance.

The induction dose is used to ease the opioid withdrawal effects when detox is in full swing and until the patient is completely weaned off the drug (heroin, morphine, codeine, oxycodone, or other short-acting opioids).

Administration of SUBOXONE® during this treatment stage is done under medical supervision at the rehabilitation center or clinic. Also, you must be already showing a moderate level of opioid withdrawal symptoms.

SUBOXONE® induction typically lasts for 3 to 4 days; until the withdrawal symptoms are stable and under control. The maximum SUBOXONE® induction dose per day is 32 mg buprenorphine / 8 mg naloxone.

As for the maintenance dose, it’s used to help the patient cope with abstinence from the opioid drug and minimize the likelihood of relapse.

Depending on their treatment plan, the doctor will determine how long the patient should stay on the maintenance dose. So, it can be anything from a couple of months up to over a year.

Similarly, the maximum SUBOXONE® maintenance dose per day is 32 mg buprenorphine / 8 mg naloxone.

Missed Dose

We’ll address missed doses only during the maintenance stage of treatment as the induction phase is fully supervised by medical staff so missing a dose is impossible.

If the patient misses a SUBOXONE® maintenance dose, they should take it as soon as they remember. But if it’s already almost time for the next dose, they should skip the missed dose and take the next one at the designated time.

Patients should never try to “make up” for a missed dose by doubling the dose at once.

Withdrawal

To avoid SUBOXONE® withdrawal symptoms, the patient should be gradually taken off the medication rather than abruptly stopping it. This process may require weeks or months.

Can You Use SUBOXONE® Alone in Addiction Treatment?

While it’s possible to rely only on SUBOXONE® for treating opioid misuse disorder, the results won’t be as effective as if the medication were used in combination with supervised care, therapy, and counseling.

Conclusion

SUBOXONE® can be highly effective in opioid addiction treatment when incorporated into a structured medication-assisted treatment plan with monitored care, behavioral therapy, and counseling. At Illinois Recovery Center, we’ll help you determine if SUBOXONE® is right for your or your loved one’s condition and create a personalized plan based on your recovery needs.

References

• https://www.ncbi.nlm.nih.gov/books/NBK459126/
• https://www.federalregister.gov/documents/2021/04/28/2021-08961/practice-guidelines-for-the-administration-of-buprenorphine-for-treating-opioid-use-disorder
• https://www.hca.wa.gov/assets/billers-and-providers/MAT_buprenorphine_products.pdf
• https://www.samhsa.gov/sites/default/files/quick-start-guide.pdf
• https://nida.nih.gov/publications/drugfacts/naloxone
• https://www.suboxone.com/pdfs/prescribing-information.pdf

SUBOXONE® is a registered trademark of Indivior UK Limited. IRC is not affiliated with Indivior UK Limited or its affiliates (“Indivior”), and any reference to it or its intellectual property is for informational purposes only and is not endorsed or sponsored by Indivior.