Suboxone and methadone are the two leading medications available for the treatment of opioid addiction. They are both opioid replacement therapies that, when taken regularly, will prevent an individual from experiencing opioid withdrawal sickness. Suboxone was approved by the FDA in 2002, and this allowed local physicians to begin prescribing Suboxone from their offices to opioid addicted patients seeking help.
This was a landmark achievement in consumer choice and provided people another very useful option for dealing with opioid addiction. To treat a patient with suboxone, a physician must first complete a comprehensive course, and become approved, before being allowed to prescribe the medication.
Since opioid replacement medication by itself addresses only the underlying physiological dependence (but not the related psychological contributors to addiction), patients are required to obtain substance abuse counseling as a part of their suboxone treatment. This additional requirement helps to ensure that patients are receiving education & training in understanding their addiction, and in identifying methods for preventing opioid relapse in the future.
Many suboxone-approved physicians do not provide this supplemental addiction counseling, and will consequently refer their suboxone patients to local providers who offer drug treatment services.
While suboxone and methadone are similar in action, they are unique enough to offer distinctly different advantages. You can review our comparison chart to examine some of the differences between the two medications. Both methadone and suboxone are slow acting, long lasting opioid agonists that bind to the body's opiate receptors. This particular action eliminates opioid withdrawal sickness very effectively, and thus allows individuals to resume their daily lives.
Suboxone is actually a branded medication & product of the pharmaceutical company, Reckitt Benckiser. Suboxone is currently available as a thin film that is held under the tongue until the medication dissolves. Once dissolved, the medication is naturally absorbed through the tissues under the tongue and into the bloodstream. The newer film formulation dissolves somewhat more quickly than the previously available tablet form.
Suboxone is generally taken once per day although some patients with a milder opioid dependency may be able to take the medication every other day and remain comfortable. Suboxone does not produce a drug high for tolerant users, and does not interfere with one's daily activities. Many patients report feeling very comfortable while being maintained on suboxone and also during their gradual taper off of the medication.
What is in Suboxone?
Suboxone is a combination of buprenorphine and naloxone. Buprenorphine (an opioid agonist) is the ingredient that binds to opiate receptors and provides relief by blocking withdrawal symptoms (very similar to methadone). Naloxone is an opioid antagonist that reverses the effects of opiates and will cause withdrawal. This seems like a strange paradox having both ingredients in one tablet. However, do not worry. Remember, Suboxone is dissolved and absorbed under the tongue. The antagonist, Naloxone, becomes inert (has no effect) when dissolved under the tongue. So one only experiences the benefit of the Buprenorphine.
Why is Naloxone Added to Suboxone?
Specifically to discourage & prevent injection use of suboxone. Some addicted individuals may try to inject suboxone to obtain a drug high. When they do so, the Naloxone becomes immediately active (since it's being injected directly into the bloodstream), and it brings on sudden withdrawal symptoms making the individual feel very sick. This reinforces a person for using suboxone the proper way (under the tongue), and prevents future attempts at injecting suboxone.
How Do I Know if Suboxone is Right For Me?
This is a great question although a little difficult to answer. Suboxone tends to be effective for a considerable number of people addicted to opioids. Many of those who do well with suboxone are people who have a relatively shorter duration of opioid addiction or whose addiction is based on a comparatively smaller amount of daily opioid use. Heavy opioid users with a longer history of addiction sometimes respond better to methadone. However, there are notable exceptions.
Suboxone has a ceiling effect around 24-32 mg of medication daily. 32 mg is generally considered to be the dose at which maximum withdrawal relief is provided. For most addicted people, taking more than 24-32 mg of suboxone daily will not provide any more additional relief. Methadone has no such ceiling effect and its dosage levels can be raised much higher, consequently providing a greater level of comfort and symptom relief for more severe opioid dependencies.
In conclusion, 8 mg to 32 mg of suboxone may provide excellent relief for someone new to medication-assisted recovery. If they find that suboxone is not strong enough to manage their withdrawal symptoms, then methadone most certainly will since it has no "ceiling effect".
Taper programs aim to stabilize an opioid addicted individual on suboxone for a brief period of time and then taper their dosage down over a 60 to 90 day period. This taper period is not set in stone and can vary depending on the individual's need. The primary goal is to stabilize with suboxone and to then taper off with the end result being complete freedom from opioids and opioid replacement medication. Some patients do very well with a scheduled taper. Other patients may find that tapering is problematic and will switch to a period of maintenance. Maintenance with suboxone is effective and safe, just like with methadone. Upon first entering the market, Suboxone was mostly used for tapering off of opioids. However, it is commonly used today for extended maintenance in similar fashion to methadone.
For more on Suboxone Doctors, read: www.Methadone.us/suboxone-doctors/
Their inpatient facilities provide approximately 9200 beds in 37 states including the United States, United Kingdom, and Puerto Rico. The company’s outpatient addiction services specialize in opioid addiction and medication-assisted treatment for those suffering with heroin and other opioid dependencies. Each Acadia clinic utilizes methadone and suboxone in their overall treatment.
Acadia recently acquired CRC Health Group and in so doing raised their total number of opioid treatment programs to about 90 – currently making them the single largest provider in the United States.
Acadia just added 10 more clinics to Methadone.US and site visitors can find more information about Acadia’s Opioid Treatment Programs by visiting these recently added cities on the Methadone.US website:
Drug and alcohol addiction are treatable illnesses. They can be successfully managed and “arrested” such that they do not continue to harm a person’s life or compromise their health. Just as with any progressive illness, a patient should commit to a course of treatment that has been proven to eradicate their illness or reduce its impact. Heart disease, cancer, diabetes, morbid obesity, alzheimer’s – all of these have established medical treatments which can increase a person’s chance of survival and/or quality of life.
Addiction is both a physiological and behavioral illness. With opioid addiction in particular, there is a strong biological/physical basis as well as a highly significant psychological component. When both of these are adequately addressed, a patient has a new opportunity to recover.
For most individuals with a severe opioid addiction, is critically important to receive physical relief from the discomfort of opioid withdrawal symptoms. But this must also happen in conjunction with behavioral health counseling. Counseling addresses the emotional & psychological factors that contributed to the development of addiction in the first place, and counseling teaches the skills necessary to remain drug free over the long-term and to hopefully avoid future relapses.
Many people find that if they neglect one of these two key areas, then they are more vulnerable to relapse and rapid deterioration. When opioid detox is not a viable option for a particular patient, methadone and suboxone are clearly the medications of choice for addressing opioid withdrawal. Counseling provides the other half of the equation. All methadone programs across the country (as well as all suboxone-approved physicians) are required to insure that their patients are receiving some level of addiction counseling.
The essential ingredient is this mix is patient commitment. Having a genuine desire for a drug free life is as important as anything else. Becoming ready for change is a process in itself and varies from person to person. It is true that many people find their way into recovery because of a recent crisis in which things get so bad they hit a new low, or bottom. This does not have to happen though.
Sometimes hitting “bottom” brings with it dire consequences. If you have been contemplating making a change, please remember that it is not too late. There are many advantages to acting today as opposed to waiting another day. Addiction loves procrastination. Recovery begins now with your commitment to doing something about your problem!
Palm Partners is a drug rehabilitation and recovery program located in Delray Beach, Florida. The organization provides a 24 hour hotline for individuals interested in learning about addiction treatment options.
Their website also provides an online chat alternative for speaking with an addiction counselor. Individuals facing addiction often alternate between being sick & tired of what they are going through and just giving in to the addiction as a result of being tired of the fight. Apprehension and feelings of fear have kept many addicted people from actively seeking help.
Speaking with supportive professionals (as well as others in recovery) can provide hope that people really can recover, and regain their quality of life.
From year to year, there has been a continual rise in the United States in the prevalence of addictive disorders. Over the past 5 years in particular, opioid addiction has moved into the forefront of both media coverage and general public awareness.
Some professionals contend that addiction treatment resources have shrunk over the last 15 years as a result of cuts in state funding and third party insurance coverage. What the next few years holds remains a question at this point in time. While there is interest in expanding addiction treatment services across the country, government funding is limited due to the growing national deficit and inability of government leaders to revitalize the economy through appropriate business incentives.
A new mobile phone app for recovering people was released last month by Elements Behavioral Health based out of Long Beach, California. The app is called Cassava and it provides a number of nifty features such as a daily reflection, a support group meetings finder based on your location, and a personal sobriety tracker that measures one’s number of days drug free.
In addition to days sober, the app allows users to record in a personal journal format their moods, daily nutrition, and even sleep patterns. An important part of growth in recovery is following new disciplines and remaining aware of self-care needs. The Cassava app can function as a useful toot for recovering people aiming to feed their recovery on a daily basis.
Another potentially helpful feature of the app is the inclusion of “recovery tips”. These function as reminders and suggestions for ways to cope with relapse risks. Addicted people, particularly in the early phase of recovery, are more vulnerable to sudden urges to use and often need a means of redirecting their thinking in order to sidestep a build-up of thoughts that feed the urge to use. Reading recovery literature has always been a potentially useful action step that helps to short circuit urges and cravings.
The app is free and can be downloaded from the Apple website. While it is designed for Apple iPhone 5.0 and above, I was able to install the app on version 4.0 and it worked well.
An important consideration in examining the disease of addiction is the recognition that “recovery” is an incremental process. Many people facing their addiction will experience brief setbacks, and some will struggle for years before they are able to remain on the path of positive change.
As a counselor, I have listened to many recovering individuals talk about their resistance to change. Addiction is a persistent disease of disruptive thinking and behavior highly subject to repetition. Addicts will repeat the same bad “choices” as a result of many factors. Scientific research has shown that habitual patterns of behavior are neurochemically driven deep within the brain. These patterns can be reinforced by one’s social connections, immediate environment, and underlying belief system.
With severe levels of addiction sustained over years, it can become difficult for people to shift their lifestyle, thinking, and decision-making toward a healthy, recovery-oriented mindset. In 12 Step recovery, there is the popular expression called “hitting bottom”. This expression is typically used to describe a specific time in which a person has lost so much, or suffered such a painful crisis, that their readiness for change finally emerges. This window of opportunity is often times short-lived. Hitting bottom will compel some people to finally take the right action – to seek help – to admit they have a problem. If this happens, then a decision to step onto the path of recovery may actually occur.
Active addition is often characterized by a short range view in which consequences are not thoroughly considered. Focusing on consequences interferes with the compulsive desire to use. And even then, a recognition of consequences to oneself and family is often not enough to change the decision to get high. With opiate addiction, the decision to use is overwhelmingly controlled by opiate withdrawal sickness. This never-ending physical sickness takes people away from recovery and keeps them trapped in a desperate existence centered around doing whatever is necessary to avoid being “dope sick”.
Fortunately, this dilemma can be addressed through medication-assisted treatments (methadone, suboxone, naltrexone). These do not replace the need for a recovery program, but they become an important part of one’s overall personal recovery program. Staying on the path of recovery is the next critical phase after stepping onto the path. Medication-assisted treatment greatly aids recovering addicts in staying on the proper path. Science has proven that those with the greatest chance of long-term, successful sobriety are those that remain in treatment and recovery. Said differently, a person’s chance of recovery success is statistically improved the longer they remain in treatment.
When a person no longer has to face the crippling weight of daily withdrawal sickness, they have a chance to re-approach their overall recovery and the opportunities that lie ahead of them.