How does the Suboxone Program Work?
- If a patient decides to start on the suboxone program they have to abstain from opiate use for 24 hours before starting. The patient must be in mild to moderate withdrawal before Suboxone is administered.
- The reason for this is due to the high affinity of buprenorphine (Active component of Suboxone) to the opiate receptor.
- It binds very tightly to the receptor such that if there are any other opiates in a patients system the buprenorphine will displace them off the opiate receptor.
- The partial agonist properites of buprenorphine only partially stimulates the receptor. This leads to the rapid development of withdrawal symptoms – a complication known as precipitated withdrawal.
- If you are in mild to moderate withdrawal before starting Suboxone it will start working right away and you will soon feel better. If you are not withdrawal, starting Suboxone may make you may feel worse. Therefore, it is important for you to tell your physician if you have used opiates in the previous 24 hours.
- Starting Suboxone is termed an Induction and should only be attempted by a physician trained in the procedure.
How is pain treated if I’m taking Suboxone?
- Suboxone has been shown to be very effective in treating pain, however, it needs to be taken 3-4 times daily for that purpose.
- If one suffers acute pain while on Suboxone and your Family Physician or Dentist prescribes an opiate its effect will likely be blocked by Suboxone. As such, a higher dose of opiate may need to be prescribed.
- If you are prescribed opiates from another physician, be it your Family Physician, Dentist, or any other physician, please inform your Suboxone prescriber.
Will I become addicted to Suboxone?
- Patients taking Suboxone are already physically dependent to opioids – stopping it will cause the uncomfortable physical symptoms of withdrawal.
- However, by definition, these patients are not addicted to Suboxone even though they are physically dependent – addiction involves not only a physical need for the drug (dependence) but several undesirable behaviours that a person develops to help them get the drug.
Can I take Suboxone if I’m pregnant?
- Suboxone is NOT currently approved for use in pregnancy.
- However, it is interesting to note that the active component of Suboxone, buprenorphine, IS safe in pregnancy.
- The concern over Suboxone in pregnancy is related to the Naloxone component which in studies on rats has been linked to fetal death.
- This risk may be overstated but if you become pregnant while on Suboxone your physician will switch your therapy to Buprenorphine alone (Subutex) or if necessary to methadone.
- The preference is to switch to Buprenorphine (Subutex) since Neonatal Abstinence Syndrome (Opiate withdrawal in an infant) is less severe and requires less treatment in babies born to mothers on burpenorphine rather than methadone.
How much does Suboxone cost?
- Suboxone is covered under most drug plans. It is also covered by the provincial drug plan in Ontario (ODB).
"When you can stop, you don't want to, and when you want to stop, you can't..."
- Luke Davies
FAQ’s
How long does a dose of Suboxone last?
- Depending on the patient the half life of Suboxone can be as long as 72 hours. It is therefore useful to prevent withdrawal because of this long duration of action.
- For most patients a single dose prevents withdrawal for more than 24 hours.
Is it possible to get off Suboxone?
- It is possible to taper off suboxone, but only in consultation with your physician and only when you are clinically stable and have been abstinent from drug use for some time.
- By slowly decreasing the dose over weeks or (More typically) months patients can taper off Suboxone without having to go through withdrawal
- Patients at Vista Health Clinics will never be forced to taper off Suboxone. Many patients prefer to stay on Suboxone long term.
What are the effects of long term Suboxone therapy?
- Suboxone is very safe medication when taken as prescribed. It is not known to cause long-term damage to organs, even after years of use.
- Elevation of liver enzymes can occur in some people, however, this usually reverses once the drug is discontinued.