Opiate Medication Detox With Suboxone

About SUBOXONE

SUBOXONE is the first opioid medication approved under DATA 2000 for the treatment of opioid dependence in an office-based setting. SUBOXONE also can be dispensed for take-home use, just as any other medicine for other medical conditions.

The primary active ingredient in SUBOXONE is buprenorphine.

Because buprenorphine is a partial opioid agonist, its opioid effects are limited compared with those produced by full opioid agonists, such as oxycodone or heroin. SUBOXONE also contains naloxone, an opioid antagonist.

The naloxone in SUBOXONE is there to discourage people from dissolving the tablet and injecting it. When SUBOXONE is placed under the tongue, as directed, very little naloxone reaches the bloodstream, so what the patient feels are the effects of the buprenorphine. However, if naloxone is injected, it can cause a person dependent on a full opioid agonist to quickly go into withdrawal.

SUBOXONE at the appropriate dose may be used to reduce illicit opioid use and help patients stay in treatment by:

Suppressing symptoms of opioid withdrawal
Decreasing cravings for opioids

Treatment Walk-through

SUBOXONE treatment can be broken down into five phases that are described below:

Intake

Before you begin treatment, you will be asked questions about your medical health history, your mental health history and your substance use history, including your current opioid use. All the information you give will be held strictly confidential. At this time, your treatment expectations, as well as your doctor's expectations of you, will be discussed. You may be asked to provide a urine sample to determine the use of opioids or other drugs.

Induction

The goal of induction is to switch you from your current opioid to SUBOXONE. You MUST arrive for your induction already experiencing mild-to-moderate opioid withdrawal symptoms. This point cannot be emphasized enough. If you take SUBOXONE before you are in withdrawal, the medication will make you feel worse because it can cause withdrawal symptoms. Your doctor or nurse will assess your withdrawal symptoms and give you your first SUBOXONE dose in the office. Patients can begin to feel some relief within 20 minutes, although the full effects take about an hour, at which point your symptoms will be reassessed.

When you are ready to leave the office after your first induction visit, your doctor will give you a prescription for the amount of SUBOXONE that you will need until your next appointment, along with any special instructions related to your care. You may also be prescribed other medications to help control withdrawal symptoms.

Stabilization

During stabilization, your SUBOXONE dose is fine-tuned; the goal is to find a dose where your withdrawal symptoms and cravings are suppressed, and you experience minimal to no side effects.

Maintenance

Once your dose is stabilized, the maintenance phase of treatment begins. During maintenance, your treatment compliance and progress will continue to be monitored.

Participation in some form of behavioral counseling is strongly recommended to maximize the likelihood of your treatment success. You and your doctor will discuss counseling options that meet your needs.

Your doctor may request urine samples from time to time. Some doctors find urine testing a helpful part of treatment because by verifying the absence of opioids in your system, they can evaluate the effectiveness of your SUBOXONE dose. Talk with your doctor if you have questions about the role of urine testing in treatment.

Appointments are usually scheduled on a weekly basis; however, if treatment progress is good and goals are met, monthly visits may eventually be considered sufficient. The maintenance phase can last anywhere from weeks to years—depending on what you, your doctor, and, possibly, your therapist or counselor, determine is best for your individual needs.

Medically Supervised Withdrawal

Length of therapy is up to your doctor, you, and sometimes your therapist or counselor. In this phase of medically supervised withdrawal, your doctor will slowly taper your SUBOXONE dose, taking care to see that you experience minimal withdrawal symptoms or cravings. Your dose can always be changed if you experience uncomfortable symptoms or cravings at the reduced dose.