Many treatment facilities use medication-assisted treatment in order to help a person safely withdrawal from opiates.
As one of the most difficult addictions to break, medication is often required to help patients get through the most difficult phases of treatment, specifically initial withdrawal and detox. Some of the most commonly used medications are methadone, naltrexone, and buprenorphine (Suboxone). While these drugs are not recommended for long-term maintenance, they play a vital role during initial recovery. These medications allow people to regain a normal state of mind free from the influence of cravings as well as the highs and lows of addiction.
The Benefits of Suboxone
While there are multiple medications available for opioid addiction treatment, Suboxone’s introduction in 2002 changed the landscape. This medication has numerous advantages over methadone and naloxone due to the fact that it suppresses withdrawal symptoms and cravings while simultaneously blocking the effects of other opioid drugs for at least 24 hours. Users do not experience the negative effects of withdrawal from opioids and do not experience the euphoria associated with opioid use, should they take any other drugs.
Suboxone is a combination of two medications: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist and naloxone is an opioid antagonist. As a partial opioid agonist, buprenorphine can produce effects similar to those of full opioid agonists (heroin, morphine, hydrocodone, and oxycodone are all full opioid agonists). This means that users will get a somewhat pleasurable feeling from the medication, but most report just feeling “more energized” while under its effects. When taken as prescribed, suboxone does not cause dependency, nor does it produce euphoria or feelings of being high. Partial opioid antagonists trick the brain into believing it is under the influence of a full opioid agonist. The medication lodges itself into receptors, making it impossible for a full opioid to take effect. If someone attempted to use Suboxone to get high by snorting or injecting the pills, the naloxone would quickly to dislodge opioids from receptors, which can cause severe, almost instantaneous withdrawal symptoms. Naloxone’s purpose in Suboxone is to discourage attempted misuse of the drug.
Detoxing from Suboxone
While Suboxone is incredibly popular and helpful in the treatment of opioid addiction, it is not meant to be a long-term maintenance drug. Suboxone has some of the highest rates of success as measured by retention in treatment and year-long sobriety. Studies show that success rates range from 40 to 60 percent, making it one of the most efficient methods of treatment. Without proper support, however, many patients find themselves facing the prospect of relapse. Drugs like suboxone are meant to be “maintenance medications” that assist users during early stages of recovery. Once a person is free from the effects of all mood and mind-altering substances, use of these medications should be tapered until the patient is eventually off all addiction medication.
Many studies show that 60 to 70 percent of people who use maintenance medications like Suboxone quit using them of their own accord because they can cause feelings of intoxication or blunted emotions. Unfortunately, although the drugs help clients overcome initial stages of addiction, there is a withdrawal phase with these medications as well. Many find themselves facing withdrawal symptoms and may return to their original opiate of choice in order to cope with stress, anxiety, and other withdrawal symptoms. In the absence of structure, support, and the establishment of healthy coping mechanisms, these issues can easily trigger relapse.
Detoxing from Suboxone is similar to many “regular” detoxification programs. These focus on individual and group support as needed. Over the course of time, the dosage of Suboxone is gradually lowered—the time this takes varies depending on the initial dosage given to the patient. Clients are assessed regularly to monitor withdrawal symptoms, both physical and psychological, ensuring that the process is as comfortable as possible. In some cases, non-addictive medications are used to manage more severe or uncomfortable withdrawal symptoms. Detox programs can utilize a number of services to assist clients as they adjust to sobriety without the assistance of medications. This may include acupuncture, yoga, wellness groups, nutritional planning, massage therapy, individual and group therapy, and other services as required. Even during detox, programs are designed to uncover and address the underlying issues and triggers that enable substance abuse, helping to build a unique treatment program that will most effectively help each individual.