Is Suboxone an Opiate?

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    Is Suboxone an Opiate?

    Suboxone is a prescription medication that is frequently prescribed by physicians treating people for opioid use disorders. The medication works by alleviating the symptoms of opioid withdrawal, which can be so severe that many people without medical relief fail to follow through with their addiction treatment programs. Suboxone also helps alleviate the cravings that are associated with the detoxing process. 

    By taking the drug, individuals lower their chances of relapse and are far more likely to remain committed to sobriety. Given that Suboxone is designed to treat the symptoms of opioid addiction, it may come as some surprise that Suboxone is itself an opiate. In fact, Suboxone is a combination medication that contains two different opiates: buprenorphine and naloxone.

    What is Buprenorphine?

    Buprenorphine is the active ingredient in Suboxone that provides the relief that people with opioid use disorder require. Buprenorphine is a semi-synthetic opioid analogue of thebaine, also known as codeine methyl enol ether. The drug was originally designed over a 10 year period by researchers who were hoping to develop an opioid that would possess the same beneficial effects as other opioids without the negative side effects. The result of their research and development, buprenorphine, was a success. 

    Buprenorphine offers the analgesic, or pain-relieving, effects of other opioids, but it does not provide the same subjective euphoric and sedating effects, known as a “high.” Unlike most recreationally abused opioids, which are opioid agonists, buprenorphine does not merely activate opioid receptors. It also functions as an opioid partial agonist and an opioid antagonist, which means it actually blocks opioid receptors from being activated by recreational opioids.

    Soon after the drug was released, it became clear that it could be used in opioid replacement therapy. For decades, morphine had been the exclusive drug of choice in opioid replacement therapy, a type of treatment for opioid addiction that involves replacing recreational opioids with a safer opioid alternative under careful medical supervision. 

    Buprenorphine is effective because it satisfies the cravings that people who are addicted to opioids suffer from. It reduces withdrawal symptoms when a person quits recreational opioids. It also does not offer the same euphoric effects that are characteristic of the heroin high. By taking buprenorphine, a person can withdraw from opiates at a pace deemed appropriate by their physician. Individuals who stay on buprenorphine for considerable periods of time have lower rates of relapse down the line.

    While buprenorphine offers only limited euphoric effects when taken as prescribed, the medication can be abused. Individuals can alter the medication and inject it, which results in a greater high. To prevent this occurrence, Suboxone contains buprenorphine combined with another opioid, naloxone.

    What is Naloxone?

    Naloxone is an opioid antagonist. When people take it, the effects of other opioids are reversed, sending individuals into immediate opioid withdrawal. Naloxone, which is available by itself under the brand name Narcan, can be used to save the lives of individuals who are overdosing on opioids. 

    Naloxone is added to buprenorphine because it results in opioid withdrawal when people inject it, making would-be-abusers reluctant to misuse their Suboxone prescriptions. Naloxone is not very bioavailable when taken orally, meaning that it does not interfere with buprenorphine when Suboxone is taken as prescribed. Naloxone is included in Suboxone as a preventative safety measure only.

    How Does Suboxone Work?

    Suboxone is generally prescribed by outpatient treatment centers in the context of a medication-assisted treatment (MAT) program. Medication-assisted treatment is an addiction treatment modality that emphases a “whole patient” approach to recovery. By comprehensively addressing every aspect of addiction, ranging from the behavioral to the neurological, medication-assisted treatment programs are uniquely effective. 

    MAT programs include a range of behavioral therapy methods, such as cognitive-behavioral therapy counseling and support groups, that form the backbone of a person’s long-term sobriety. A suboxone prescription can reduce the physical and emotional symptoms during opioid withdrawal, mitigate cravings, and block the effects of other recreational opioids. Suboxone treatment is not designed to cure addiction, but to support a person’s efforts to engage in behavioral therapies that will ultimately form the foundation of their sobriety.

    There are a number of stigmas surrounding the use of opioid replacement therapy. Many people mistakenly believe that it is “wrong” to use opioids such as Suboxone to treat an opioid addiction. People hoping to achieve sobriety frequently worry that using Suboxone is a form of “cheating.” 

    The reality is that Suboxone is not like other opioids. The Suboxone high is not comparable to recreational opioids, and Suboxone overdose is difficult unless the medication is combined with other drugs, such as the combination of Suboxone and alcohol  When Suboxone is used as prescribed by people pursuing a comprehensive addiction treatment program at an outpatient treatment center, they not achieve sobriety from opioids, but they emerge from their treatment programs with a vastly improved quality of life.

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