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Understanding How Suboxone is Used in Addiction Treatment

by Landmark Recovery

July 29, 2019
Graphic of lots of pills

Updated: August 4, 2022

Treatment for Opioid-Related Addictions

If you’re unfamiliar with different forms of medication-assisted treatment (MAT), you may ask yourself, “what is Suboxone?” If this is the case, you may be able to benefit from learning more about different types of MAT that addiction treatment centers can offer. MAT is one of the commonly used methods to help those suffering from substance use disorders (SUDs) achieve sobriety.

Whether it’s methadone, Suboxone, Vivitrol, or something else, MAT has a number of benefits for people looking to free themselves from the clutches of addiction. If you or a loved one are dealing with some sort of SUD, it may be a good idea to look into treatment options from Landmark Recovery and how MAT can help.

What is Suboxone?

Package of Buprenorphine and Naloxone

Film strip version of suboxone

Suboxone is the brand name for prescription medicine that contains the active ingredients buprenorphine and naloxone. It is one of many forms of MAT that is used to treat adults who are dependent on opioids. Like all forms of MAT, Suboxone is prescribed as part of a comprehensive treatment plan that includes counseling, behavioral therapy, and social support programs. At Landmark Recovery, we use cognitive behavioral therapy (CBT) as a key part of our MAT programs.

Suboxone is considered a partial agonist form of MAT. This means that this form of therapy does not fully activate receptors in the brain, which results in a “ceiling effect” from these types of medications. Some of the common side effects of Suboxone include:

  • Respiratory problems
  • Sleepiness, dizziness, and problems with coordination
  • Dependency or abuse
  • Liver problems

Stages of Treatment with Suboxone

Traditionally, when MAT is undergone with Suboxone, there are three main steps to accomplishing a full round of treatment with the drug:

  1. Induction — This is the beginning of treatment. For the first dose, you must be in a moderate state of withdrawal. You will work with a healthcare provider to reach a dose of Suboxone that works for you.
  2. Maintenance — Healthcare providers will work with you to help you transition into the maintenance phase of the treatment in which you will no longer experience withdrawal symptoms, have minimal to no side effects, and won’t have uncomfortable cravings. During the maintenance phase, you will be working with a comprehensive treatment plan, including counseling and psychosocial support, to help patients achieve long-term sobriety.
  3. Medical Taper — The final stage of Suboxone treatment is to discontinue therapy. A healthcare provider will work with you to taper you off the medication in order to not experience harsh withdrawal symptoms.

Opioid withdrawal symptoms are usually alleviated 20-40 minutes following the first dose of Suboxone. Suboxone is a safe treatment for opioid addiction if used as prescribed. Studies have shown that Suboxone is just as effective as methadone in suppressing opioid use and is considerably safer due to its lower abuse potential and risk of overdose.

suboxone pills

Suboxone Pills

Suboxone Ingredient 1: Buprenorphine

Buprenorphine is one of the components of Suboxone. It’s used in MAT to help people reduce or quit their use of heroin or other opioids. Buprenorphine was first approved for clinical use by the Food and Drug Administration (FDA) in October 2002 and it represents a key part of a successful MAT program. Buprenorphine has properties that help to lower the potential for misuse, diminish withdrawal symptoms and cravings, and increases the safety in cases of overdose. Potential side effects of buprenorphine include:

  • Nausea and vomiting
  • Muscle cramps
  • Cravings
  • Inability to sleep
  • Distress and irritability
  • Fever

Suboxone Ingredient 2: Naloxone

Oftentimes, naloxone is added to buprenorphine to decrease the likelihood of diversion and misuse of drug products. Naloxone is a FDA-approved medication that is used to prevent overdose by opioids like heroin or oxycodone. It blocks opioid receptor sites and reverses the toxic effects of the overdose. Potential side effects of naloxone include:

  • Feeling nervous
  • Body aches
  • Dizziness or weakness
  • Diarrhea and stomach pain
  • Fever or chills
  • Sneezing

Opioid overdoses are life-threatening and require immediate emergency medical attention. Overdoses can happen when a patient misunderstands directions for use, takes an extra dose, misuses a prescription, and more.

What is Medication-Assisted Treatment (MAT)?

There are a number of different types of MAT, all of which may be effective in helping patients kick their harmful habits and achieve long-term sobriety. MAT for substance use disorder falls into three different categories: antagonist, partial agonist, and full agonist.

Antagonist

Naltrexone is an example of an opioid antagonist. A drug antagonist works by effectively blocking the activation of opioid receptors. Instead of controlling withdrawals or cravings like other forms of MAT, it works by preventing any opioid drug from producing the associated effects of euphoria that many drug users are seeking.

Partial Agonist

Partial agonists for things like opioids means that it produces effects such as euphoria or respiratory depression but these effects are weaker of those of full drugs such as heroin or even methadone. The effects increase with each dose but eventually level off producing a “ceiling effect”. This effect lowers the risk of misuse, dependency, and harmful side effects.

Full Agonist

An agonist, such as methadone, is a form of MAT that works to eliminate withdrawal symptoms and relieves drug cravings by affecting the opioid receptors in the brain. Methadone, for instance affects the same receptors that other opioids such as heroin and other opioids activate. Obviously, these three types of MAT all work in different ways to ultimately achieve the same goal: long-term sobriety. When deciding on the proper path forward treatment-wise, care providers will look at each individual patient and their circumstances and history to decide on the best method on treating their respective problems.

Other Forms of MAT

While Suboxone is one of the commonly used forms of MAT in the addiction community, there are a number of other different types of medication-assisted treatments that can be used to help those with substance use problems.

Vivitrol

When reading about MAT, you may also be wondering, “what is Vivitrol?” Vivitrol is one of the many forms of MAT that has been approved by the FDA to help treat certain substance abuse issues. Vivitrol is the brand name for naltrexone. As mentioned before, naltrexone is an opioid antagonist that blocks the activation of opioid receptors in the body. Essentially, it prevents a user from feeling the euphoric and high effects from using opioids and some other substances.

Vivitrol has shown to have a number of different benefits for those in treatment achieve long-term sobriety. For example, in a six-month study, Vivitrol users were found to be 90% opioid-free compared to 35% of people receiving a placebo. Moreover, Vivitrol users were found to have decreased cravings and were more likely to stay in treatment longer. Also, Vivitrol users were less likely to relapse to physical opioid dependence compared to those taking the placebo.

Methadone

Methadone has been used for decades to help treat people who are addicted to heroin and other narcotics. When this medication is taken as prescribed it can be a safe and effective method for helping someone overcome their substance use disorder. As with all forms of MAT, methadone is most effective when used in conjunction with treatment counseling and social support. Methadone works by changing how the brain and nervous system respond to pain. It helps to reduce the painful symptoms associated with opioid withdrawal and blocks the effects of opiate drugs such as heroin and morphine.

While methadone can be a helpful form of treatment, methadone can lead to some problems, such as overdose and even death. Methadone overdose can occur when a patient accidentally or intentionally takes more than the normal or recommended amount of the medicine.

Myths and Misconceptions About MAT and Suboxone

There are a number of concerns over MAT in the addiction community, with many urging for a complete abstinence-based approach to sobriety. However, MAT holds many benefits for the user and can help contribute to and promote their sobriety. One of the reasons for the debate in the community and among loved ones of those facing addiction is because of the misconceptions surrounding MAT.

One of the common misunderstandings about MAT is the belief that patients use these forms of medication to get high. While it is possible for those who have an opioid use disorder to get high on buprenorphine or methadone, these types of medications affect people who have a high tolerance differently. If dosed and taken correctly, they will act in the opioid receptor slights more slowly and will not produce a euphoric high. Instead, it will minimize withdrawal symptoms and cravings. This will help patients function normally and participate in other forms of treatment.

Many misunderstandings surrounding MAT come from the fact that many people don’t know or understand the differences between each type of MAT. For instance, while Suboxone and methadone may be similar in their ultimate goal, there are a number of differences between the two.

Suboxone vs. Methadone

Methadone is one of the most common and well-known forms of MAT, meanwhile, Suboxone is another type of MAT that is less known and understood. As previously mentioned, the obvious and clear difference between these two forms of treatment is the fact that Suboxone is a partial agonist while methadone is a full agonist. Again, this just means that there is a “ceiling effect” for those using Suboxone and other forms of buprenorphine while this does not exist for methadone users. However, how does this affect treatment?

While there needs to be more research into the differences and clinical effectiveness between Suboxone and methadone. Some studies have shown that Suboxone users reported fewer days of heroin use in the past month compared to groups using methadone. Moreover, in one study in which patients who had received treatment for six months with Suboxone and methadone, more Suboxone users reported being abstinent from heroin in the past 90 days compared with those treated with methadone, 71% compared to 38%. With this said, methadone, while dangerous if not taken properly, can help improve a person’s situation and can contribute to long-term abstinence and sobriety.

Drug and Alcohol Addiction Treatment

As mentioned before, MAT is most effective when it’s combined with other treatment efforts like behavioral counseling and CBT. For those who are looking into addiction treatment options, it’s important to learn more about the details of treatment.

Detoxification

For many who enter drug or alcohol rehab, they will go through a medically assisted detoxification program to ensure that they safely withdrawal from their respective substances. This is generally where MAT first comes into play. MAT can be used to help patients deal with harmful withdrawal symptoms. Medically assisted treatment is one of the most important parts of drug and alcohol treatment as it helps a patient deal with the initial withdrawal symptoms in a safe environment that will keep them safe.

Therapy

Following detox, patients will likely go through many forms of therapy and counseling to help them learn about the details of addiction and the benefits of sobriety. Some common types of therapy include group counseling, family therapy, and CBT. CBT is used to help patients and clinicians identify stimuli that can work to trigger a craving or urge that may potentially lead to a patient using again. The patient and therapist will work together to come up with solutions and strategies for dealing with these triggers, essentially creating a plan to help a patient avoid relapse.

Take the Next Steps in Your Recovery

MAT, if done correctly, can be a great tool to help patients overcome their substance abuse issues. There are a number of different forms of MAT, like Vivitrol and Suboxone, that can help patients deal with the painful withdrawal symptoms associated with newfound sobriety. Detox is one step in overcoming an addiction.

Learning more about types of MAT can help you feel more comfortable if you decide that treatment is the right option for you or your loved one. If this is the route you choose, the next step is finding an addiction treatment center that offers these levels of care. Landmark Recovery is an alcohol and drug addiction treatment center dedicated to helping those struggling with substance abuse.

If you still have questions like, “how can Vivitrol help?” or “what is Suboxone?” call 888-448-0302 to speak to a recovery specialist. Our staff is available 24/7 to give you more information on our MAT programs and guide you through the admissions process. Visit our locations page to find a treatment center in your area.

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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.