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About Suboxone (Buprenorphine) Treatment
What is Suboxone®?
Here at New Braunfels Psychiatry, we specialize in the treatment of opioid dependence with Suboxone®(buprenorphine/naloxone). Dr. Senyszyn has been treating opioid dependence with buprenorphine for over 12 years. Suboxone® is the branded name for the combination drug buprenorphine/naloxone. It is a recommended treatment to assist in recovery from opioid addictions, and works by minimizing extreme physical dependence and withdrawal symptoms that result from opioid addiction.
Like Methadone, Suboxone® is an extremely effective treatment for opioid addictions, and up to 60% of users are able to abstain completely while on the drug. Considering the strength of opioid addiction and the physical withdrawal symptoms that result from quitting, these results are extraordinary. It is safe to say that almost any person undergoing treatment for an opioid addiction will be given Suboxone® or methadone as part of their recovery program. While equally effective, Suboxone® brings one added benefit: if abused, it does not bring about the risk of respiratory arrest.
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Suboxone® alone is not considered a cure or complete treatment for opioid addiction. It is most often used in conjunction with other treatment options, such as therapy, education and skills training, and treatment for other mental illnesses.
Opiate addiction often results from abuse of prescription drugs. Opiates are commonly used for the treatment of chronic or extreme pain, and dependence from long-term use may lead to addiction. Opiates are known for the euphoric high that they produce, and many people purposefully seek them out to experience this high. Opiate addiction develops very quickly, and can be seen within a few days of using a very high dose. Use of opiates is on the rise, with prescription and street drugs being abused throughout the world.
Without drugs like Suboxone®, addicts would rarely be able to overcome the physical nature of their addiction to engage in the emotional work of therapy and education programs. Suboxone® is an essential tool in the recovery from opioid addiction.
Understanding Opioid Addiction
Opioid addiction is a rising problem in the United States and in much of the developed world. There are a few reasons for the increased use of the drugs. First, in many cases, they are deemed medically necessary. Opioids may be the only pain-killers strong enough to handle pain from some chronic illnesses and injuries, and are often prescribed to maintain quality of life, despite these risks. Used responsibly, opioids can be very effective for pain management, and many people are able to live a normal life because of them. However, abuse of opioids is known to induce an extreme high, with euphoric feelings, and dependence from their overuse can develop very quickly. Opioid abuse is characterised by:
- Development of tolerance, someone needs to take more and more of a drug to feel the effect. This is often a slippery slope that allows a prescription to become an addiction
- Persistent willingness and attempts to quit using the drug, and inability to successfully do so
- Obtaining opiates becomes a central focus of life, taking priority of other activities and sometimes leading to financial damage
- Continuing the use of the drug despite negative consequences such as the loss of a job or spouse
- Using more medications than prescribed, or working to have medications increased by visiting multiple physicians
- Feeling sick and beginning to show withdrawal symptoms if drug is not taken
Opiate addiction can set in quickly, and can emerge in people who would not seem likely to engage in addictive behavior. However, most people diagnosed as addicted to opiates suffer from at least one other mental health disorder. These disorders are typically depression, anxiety, bipolar disorder, PTSD, or other substance use disorders. Opioid addiction may develop as one attempts to self-medicate the pain of these symptoms.
The addiction to opiates is so intense because there is an emotional and physical element. People take the drug to remove emotional pain, and then physical dependence makes it nearly impossible to stop. It is unlikely that an opiate addiction can be broken without professional support. Withdrawal symptoms tend to be intense, and are often unbearable to sufferers, and it is important to get addicts through the hurdle of withdrawal if they are to recover from addiction emotionally. Removing withdrawal as a hurdle to recovery increases the likelihood of success, and actually makes it possible for many people.
Research has shown that, genetically, some people may be more prone to opioid addiction than others, and they may find recovery more difficult. Some research has shown that, even in people that have been recovered from their addiction for years, there is still an observable change to opioid reception in the body.
Withdrawal from Opioid Addiction
Physical withdrawal from opioid addiction is intense and frightening, and presents as extreme physical illness. Withdrawal almost always requires medical intervention, and the symptoms can be reduced and almost eliminated in the majority of addicts. In the early symptoms of withdrawal, addicts may experience:
- Extreme anxiety, agitation, and restlessness
- Muscle and body aches
- Tearing eyes, runny nose, sweating and yawning
- Extreme insomnia
These feelings are part of what prompts people to continue to use opiates. The longer they are without the drug, the more intense their discomfort. Late-stage withdrawal symptoms include:
- Stomach pain and abdominal cramping; inability to eat
- Diarrhea, nausea, and vomiting
- Goose bumps, fever, and body sweats
Late stage symptoms are very uncomfortable and frightening, and may feel like medical emergency. That said, they are usually not life threatening, and people can (and have) successfully go through withdrawal without medical intervention, though it is not advised.
Detox alone does not constitute adequate treatment for opioid addiction, and many years of professional support may be required before someone is completely “free” of their addiction. Physical cravings, depression, low energy last far beyond the days and weeks of withdrawal, and Suboxone® helps hold this at bay while patients attend therapy and rebuild their lives. Addiction is also rooted in physical pain. Particularly because other mental illnesses are likely to be present, it is absolutely essential that therapy and education be part of the recovery process.
How does Suboxone® Help?
Suboxone® is a commercial name for combination medication buprenorphine/naloxone, which is prescribed under a few different names. Suboxone® is a form of Opioid Replacement Therapy (ORT). The drug works by replacing the consumption of opiates, and minimizing symptoms of withdrawal and drug cravings. Suboxone® works because it is itself an opiate, albeit one with less ill-effects than those that produce a euphoric high. Suboxone® prevents full-blown physical withdrawal symptoms, and minimizes cravings for a drug of choice. These benefits allow people to heal and seek therapy, and heal while they rebuild their lives.
ORT is the single most effective treatment for opioid addiction. It helps people to stop or reduce consumption, and in turn to stabilize their lives. Beyond personal impact, the overall benefit for larger society are huge. People addicted to opiates may neglect their responsibilities and families, and opiate cravings are so strong they may drive people to crime to fulfill their cravings. Up to 65% of users maintain complete opiate abstinence while on ORT therapy, and up to 75% are able to lessen their usage. The management of withdrawal symptoms removes one of the most difficult physical barriers to opiate addiction recovery.
The Impact of Opioid Addiction
Opioid addiction can be incredibly isolating and damaging. It is so strong that many people become focused solely on fulfilling their need to take in the drug, and leaves many people unwilling or unable to attend to their lives and personal care. When this addiction develops, employment, hobbies, family and friends are all put at risk, and over time they may lose the stability they need to overcome addiction.
Physically, opioid addiction can lead to lethargy, paranoia, hallucinations, nausea, constipation, and respiratory depression. These can all be life threatening, and the possibility of an overdose is always a risk factor.
In the long-term, brain damage and liver damage may result from abuse of the drug. Brain damage is the result of lack of oxygen, which results from respiratory depression. Liver damage may result as the body struggles to process massive quantities of the drug, and over time can be very dangerous.
There is also increased risk of injury, neglected nutrition, and other medical problems as addicts have a tendency to neglect their personal care. Sadly, as their addiction progresses, many end up homeless and without a support system as their lives fall away in pursuit of the drug.
Suboxone® as Part of a Treatment Regimen
Addiction to opiates is incredibly powerful, and can be difficult to beat. Rarely are people able to beat the addiction without some form of medical support, and no single treatment regimen works for all people. In most cases, a combination of drug therapy, psychotherapy, and education are part of the treatment program. Recovery from addiction is generally a long-term process, and without support, many addicts are sadly likely to relapse.
This combination of treatment is essential because opioid addiction almost always appears in conjunction with another mental health issue, such as depression, PTSD, or bipolar disorder. These illnesses are often part of what makes people susceptible to an addiction, as they are looking to resolve bad feelings in their lives and are therefore more likely to seek negative coping mechanisms.
It is important to address the emotional, psychological, and physical factors that combine to create an addiction to opiates. If all of these factors are not treated, the risk of relapse is much higher.
Suboxone® Side Effects
As Suboxone® is, in fact, a form of opiate, the side-effects are very similar to other opiate drugs. Users may experience drowsiness and dizziness, headache, nausea, upset stomach and vomiting, excessive sweating, itching, decreased sex-drive, constipation and urinary retention and in extreme reactions, respiratory depression that can even be fatal.
Suboxone® does carry a risk of dependence, and is generally used to wean someone off of their drug of choice. Once this phase is completed, users are generally put on a stabilized and long-term dose that will allow them to function without impact, or gradually weaned off the dosage.
Methadone is another popular treatment for opioid addiction, and many have successfully used methadone as an effective support in addiction recovery. Suboxone® differs from methadone in that buprenorphine can be prescribed in a clinic setting. It also has less risk of overdose when used alone.
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More information on Suboxone® and Opioid Addiction
For general information on Opioid addiction and treatment, visit https://www.apa.org/monitor/2013/06/addiction.aspx
If you’d like to find out more about how Suboxone® can be an effective treatment for opiate addiction, you can find out more here: https://psychcentral.com/lib/how-is-suboxone-treatment-different-than-drug-abuse/
Listings of opiate addiction recovery hotlines and support groups can be found here: https://www.samhsa.gov/find-help/national-helpline
If you are feeling suicidal, or have a loved one you are worried about, information on contacting the Suicide Prevention Lifeline is available here: https://suicidepreventionlifeline.org/
New Braunfels Psychiatry Treats Opioid Addiction (Narcotic Dependence, Opioid Maintenance Treatment) in the Central Texas region covering New Braunfels, Canyon Lake, Seguin, San Antonio, San Marcos, Stone Oak, and surrounding areas.