Suboxone is a medication that is most commonly prescribed to treat people suffering from opioid use disorder. Like the somewhat more well-known medication methadone, Suboxone alleviates many of the more painful symptoms of opioid withdrawal. It also mitigates the strong cravings that people generally experience while detoxing off of opioids. Suboxone treatment is a type of medication-assisted treatment (MAT).
Medication-assisted treatment is an evidence-based treatment modality for addiction that involves a combination of medication, psychotherapy, and other life interventions. Unlike methadone, which can only be prescribed in the context of specifically licensed treatment centers, Suboxone is legal for physicians to prescribe on an outpatient basis. Nonetheless, it should be understood that Suboxone is meant to be part of a comprehensive treatment plan.
The reason Suboxone should never be used without guidance is that Suboxone, while helpful for treating withdrawal when taken as prescribed, is a powerful opioid drug. Like other opioids, it can be abused. When people misuse or abuse Suboxone, they risk switching from one opioid addiction to another. Suboxone, like other opioids, can potentially inflict enormous damage on a person’s life, health, and well-being.
Unfortunately, many people are under the mistaken assumption that Suboxone is a completely safe drug that they can use without fear. This couldn’t be further from the truth. In 2019, Invidior, the pharmaceutical company behind Suboxone, discontinued the production and sale of Suboxone tablets. This was their response to lawsuits alleging that Suboxone pills were being abused by children and infants. The other most common form of Suboxone, Suboxone film, sometimes known as Suboxone strips remains a common route of administration for the drug. Nonetheless, Suboxone stips are also easily abused.
What are Suboxone Strips?
Suboxone strips are a formation of Suboxone that is meant to be dissolved sublingually, either under the tongue or against the cheek. They usually dissolve in a person’s mouth in under a minute and rapidly provide a dose of Suboxone. In severe cases, patients are sometimes given a dose of two strips, in which case they should place the second strip on the opposite side of their tongue to prevent overlapping.
Suboxone film is not an over-the-counter drug and can only be prescribed by a physician. They are available in different doses, though most people going through withdrawal can become stable by taking between 12-16 mg a day. However, the correct dosage for an individual can only be determined by a licensed medical professional who is experienced with treating opioid addiction.
What is Buprenorphine?
Buprenorphine is the main ingredient in Suboxone. It may come as a surprise that the main component of a drug designed to treat opioid dependence is an opioid itself. However, buprenorphine is unique in that it does not offer the same intoxicating euphoria that most recreational opioids do. In fact, buprenorphine affects opioid receptors in the brain in an entirely unique way.
When individuals take buprenorphine, opioid receptors become limited in their ability to release dopamine, the “reward chemical” responsible for opioid dependence. Buprenorphine also prevents recreational opioids from delivering the same high that they normally do. By taking buprenorphine, individuals therefore find relief from the side effects of opioid withdrawal and reduce the intensity of their drug cravings.
What is Naloxone?
Nonetheless, buprenorphine by itself can be abused when it is injected. The second ingredient found in Suboxone strips is naloxone, an opioid antagonist that blocks opioid receptors and reverses the effects of opioid highs. While buprenorphine can be tampered with so as to be injected, the additional presence of naloxone would send the drug user into immediate opioid withdrawal. Fortunately, when Suboxone strips are taken sublingually as prescribed, naloxone has a limited effect, so it does not interfere with the efficacy of buprenorphine.
How Do People Abuse Suboxone Strips?
Suboxone strips can be abused by people holding legitimate prescriptions and by those who illegally purchase the medication in the black market. Prescription holders will sometimes misuse their prescriptions by taking more of the medication than prescribed.
This often involves placing multiple Suboxone strips under the tongue. Doing so is unlikely to result in a satisfactory high, given Suboxone’s limited potential for intoxication. Most people abuse Suboxone because they are seeking relief from the symptoms of withdrawal. Nonetheless, as an opioid, abuse and misuse is likely to result in Suboxone addiction.
Those suffering from Suboxone addiction may be tempted to dissolve Suboxone strips in water so as to inject the drug. For many opioids, this is an effective route of administration that results in a stronger high. However, the naloxone present in Suboxone is more potent when it is injected.
Therefore, when people inject Suboxone, Suboxone side effects are different. The primary effect is that they will go into immediate opioid withdrawal — generally the last thing opioid addicts are seeking. Unsupervised withdrawal can not only be painful, it can be dangerous, especially for people with underlying health conditions.
Individuals who abuse Suboxone in combination with other drugs of abuse have the highest risk profile. Mixing Suboxone and alcohol or Suboxone, Suboxone and benzodiazepines, or Suboxone and cocaine can increase the risk of an overdose. If an individual is mixing Suboxone and other drugs, it is clear that they are not using it safely as prescribed and need medical treatment as soon as possible.
While Suboxone is designed to have a limited high, people who are seeking relief from opioid withdrawal symptoms can abuse the drug. While this medication is helpful in the context of a supervised addiction treatment program, when it is abused it can lead to health complications.
If you or a loved one is seeking relief from opioid addiction, the best course of action is to enroll in an outpatient program that can help design a medication-assisted treatment program for you. Not only will you get the right dose of Suboxone for you, but you will gain the skills and support you need to maintain sobriety over the long term. Recovery is possible if you’re willing to ask for help. Reach out today.