Suboxone is a prescription medication sometimes used to help people withdrawing from powerful opioid substances such as heroin, morphine or oxycodone. However, this medication also contains an opioid (a substance called buprenorphine). This means that, when misused, it can trigger or support addiction instead of acting as an addiction treatment. If you or your loved abuse Suboxone, detoxification (detox) is a common first step toward recovery. Suboxone detox follows the same general pattern as detoxification from other opioid drugs and medications. Only qualified addiction specialists can reliably and safely guide this process.
Suboxone contains buprenorphine in combination with a second medication called naloxone. While buprenorphine is an opioid, naloxone is an anti-opioid. This means that it prevents opioid substances from producing their normal effects inside the brain. The manufacturers of Suboxone combine naloxone with buprenorphine in order to limit buprenorphine’s window of usefulness. When taken together, naloxone will stop buprenorphine from reaching the brain after a relatively short amount of time. In theory, this feature makes Suboxone less attractive as a target of abuse for people who receive the medication as an opioid withdrawal treatment or use it without a prescription. However, in reality, some people use Suboxone inappropriately and develop significant problems.
Since Suboxone contains an opioid, people who go through withdrawal experience the same symptoms as people who go through withdrawal after consuming other types of opioids. In a person accustomed to powerful opioids such as oxycodone or heroin, the symptoms of Suboxone withdrawal may be relatively moderate or mild. However, in a person not accustomed to consuming powerful opioids, Suboxone withdrawal may produce stronger symptoms.
Certain symptoms appear in early stages of withdrawal, while others appear later in the process. The list of possible early symptoms includes:
- Unusual sweatiness
- Unusual tear and mucus production (i.e., watery eyes and runny nose)
- Mental agitation
- Anxiousness or restlessness
- An inability to sleep soundly
- Joint or muscle pain
The list of symptoms that can appear later includes:
- Abdominal pain
- Loose bowels
- Nausea and vomiting
- Goose bumps
- Pupil dilation
Throughout the withdrawal process, Suboxone detox can also lead to recurring cravings to start using opioids again. A questionnaire called the Clinical Opiate Withdrawal Scale can help doctors gauge the strength of Suboxone withdrawal and develop an appropriate treatment plan. This questionnaire can reveal the presence and intensity of early withdrawal symptoms, as well as later symptoms.
Suboxone treatment is common for people withdrawing from other opioid drugs and medications. However, for obvious reasons, use of the medication may be inappropriate for people with Suboxone dependency/addiction problems. In all cases, the doctor conducting treatment will take any relevant factors into account a devise a plan that best suits you or your loved one. One potential option for this plan is a clonidine, a medication that eases the discomfort of opioid withdrawal by addressing several common physical and mental/psychological symptoms (e.g., muscle aches, agitation, anxiousness and unusual sweatiness). A second medication, called naltrexone, may help prevent a relapse back into opioid abuse.
How Long Does Detox Last?
Like other forms of detox, Suboxone detox is somewhat unpredictable. Depending on a number of factors (including the seriousness of withdrawal symptoms and the length and intensity of opioid use), you or your loved one may progress through this process relatively slowly or relatively quickly. People who have abused opioids for a long time (whether buprenorphine or some other substance) commonly require a longer detoxification process than people with a brief history of opioid abuse.
What Happens Next?
After completion of detox, the next step is enrollment in a substance treatment program designed to help people affected by opioid abuse/addiction. Medication use may continue in this program. However, the core of active treatment is typically counseling or therapy intended to help you or your loved one understand why substance abuse begins, recognize existing behaviors that support substance abuse and learn new behaviors that support a substance-free lifestyle. Participation in a mutual self-help program may add to the benefits of active treatment.
U.S. Food and Drug Administration: Medication Guide – Suboxone http://www.fda.gov/downloads/Drugs/DrugSafety/UCM225677.pdf
Substance Abuse and Mental Health Services Administration: Buprenorphine http://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
U.S. National Library of Medicine – MedlinePlus: Opiate and Opioid Withdrawal https://medlineplus.gov/ency/article/000949.htm
National Institute on Drug Abuse: Clinical Opiate Withdrawal Scale https://www.drugabuse.gov/sites/default/files/files/ClinicalOpiateWithdrawalScale.pdf