Suboxone Abuse and Withdrawal Symptoms
Suboxone is a prescription medication used to treat heroin addiction, during medical detox and inpatient rehab.
Read on to learn more about Suboxone, therapeutic benefits and risks associated with its use, and how to get help if you or someone you love has developed an addiction to Suboxone.
The History of Suboxone
Suboxone is a combination of the drugs naloxone and buprenorphine. In 2002, the FDA approved buprenorphine for prescription use to help people struggling with heroin addiction. It was developed as an alternative to methadone, which had been the medication of choice in the United States and Canada but was starting to show trends of increased abuse.
Since buprenorphine’s approval, drug companies developed two prescription versions: Subutex, which is pure buprenorphine (now discontinued), and Suboxone.
Buprenorphine is a partial opioid agonist, meaning it binds to the opioid receptors in the brain, just like oxycodone or heroin. When taken as directed at prescribed doses, buprenorphine prevents other opioids from binding to these receptors, stays on them for a long time, and does not induce euphoria.
However, because buprenorphine does have some effect on the brain, some people misused the drug in large doses or by injecting it intravenously to get a rapid high. Adding naloxone, an opioid agonist, was supposed to prevent abuse by stopping buprenorphine from binding to opioid receptors in the brain if the drug was not taken as prescribed.
Instead, naloxone would bind to those receptors, forcing the person to experience withdrawal symptoms.
Trading One Addiction for Another?
Many critics assert that medication replacement drugs, like buprenorphine and methadone, simply trade one addiction for another. But supporters, like the National Alliance of Advocates for Buprenorphine Treatment, believe treating an addiction to heroin, fentanyl, or prescription painkillers with a slow Suboxone or buprenorphine taper does not continue the problem of addiction.
While people who use Suboxone as prescribed may develop a physical dependence on this drug, they also have a physical dependence on their previous opioids. The point of Suboxone is to allow the person to feel normal, attend rehabilitation and therapy to understand the compulsive behaviors of addiction, and make lasting changes to avoid heroin or prescription painkiller abuse.
While an individual undergoes this process, they take Suboxone or another buprenorphine medication, with a doctor’s supervision. This eases withdrawal symptoms, helps avoid relapse, and allows the body to slowly taper off dependence to any opioid or partial opioid agonist.
However, research does suggest that buprenorphine has abuse potential. Findings from a 2011 report published in Current Drug Abuse Reviews noted the following:
- Buprenorphine’s efficacy in treating opioid use disorders
- The substance’s documented potential for intoxication in people who have no or little existing tolerance to opioid drugs
- Buprenorphine’s positive reinforcement properties, like other opioids, meaning it impacts the brain’s reward system and releases neurotransmitters like serotonin, which are associated with elevated mood
- Buprenorphine became a substance of abuse in areas in Europe and Asia where people lacked easy access to heroin
With so many prescriptions in the U.S., large amounts of Suboxone are misused or diverted for non-medical uses.
Signs of Suboxone Intoxication
Signs of Suboxone intoxication may look like other opioid intoxication and include:
- Confusion.
- Delirium.
- Altered mental status.
- Sleepiness.
- Poor judgment.
- Pinpoint pupils.
Why Is Suboxone Abused?
There are a number of reasons why Suboxone has become a substance of abuse. These reasons include:
- Diversion into illicit markets and misuse by people who do not have a tolerance for opioids.
- Lack of rigorous training requirements for prescribing physicians.
Additionally, a large number of people in prison abuse Suboxone or generic buprenorphine because they are less able to get heroin while incarcerated. Because Suboxone comes in filmstrip form, it is easier to sneak in through letters or cards.
While not easy to find, Suboxone is frequently diverted. The Department of Justice (DOJ) noticed diversion problems with Suboxone as far back as 2004, a mere two years after buprenorphine was approved by the FDA. The DOJ’s findings included the following:
- People who misused Suboxone were more likely to struggle with addiction to low doses of narcotics
- People were successfully snorting it without naloxone preventing their high
- Mixing buprenorphine and methadone enhanced overall opioid euphoria, while mixing buprenorphine with heroin did not increase the high associated with either drug
Side Effects of Suboxone Misuse
Suboxone misuse can lead to severe health consequences. Side effects from abusing Suboxone include:
- Stomach pain.
- Headaches.
- Constipation.
- Vomiting.
- Sweating.
- Trouble sleeping or staying asleep.
- Loss of appetite.
- Low energy.
- Trouble breathing.
- Liver damage.
- Changes in blood pressure.
- Tooth decay and poor oral health.
Overdosing on Suboxone
Per SAMHSA, in their 2010 Drug Abuse Warning Network (DAWN) Report, buprenorphine was increasingly found in people being admitted to the emergency room. In 2005, there were 3,161 ER admissions involving buprenorphine; by 2010, that number had increased to 30,1353.
Signs of a Suboxone overdose include:
- Slow or irregular heartbeat
- Irritability, tension, or mood swings
- Loss of coordination and stumbling
- Sleepiness or falling unconscious
- Trouble concentrating
- Nausea, vomiting, or stomach pain
- Seizures
People who have struggled with addiction to a stronger opioids like heroin or OxyContin are not as likely to experience a high from Suboxone. However, people who have not developed a tolerance to other opioids will experience euphoria from Suboxone. For these individuals, overdosing on Suboxone is much easier—a little goes a long way.
In addition, mixing Suboxone with other drugs, like methadone, benzodiazepines, or alcohol, is also likely to enhance the effects of buprenorphine. Naloxone does not block alcohol or benzodiazepines, which may complicate overdose symptoms involving Suboxone and other drug combinations.
An overdose is an emergency. If you suspect you or someone you know is experiencing an overdose, call 911 immediately.
Withdrawal From Suboxone
Because Suboxone contains a long-acting partial opioid agonist, the drug’s half-life is longer than shorter-acting, more intense opioid drugs like heroin. This makes withdrawal complicated for some people, so it is important to get a doctor’s help to ease off this medication with a taper.
Buprenorphine’s half-life is between 24 and 42 hours, so Suboxone withdrawal symptoms may not begin until 1–2 days after last use. about withdrawal symptoms beforehand.
Symptoms of withdrawal from Suboxone can include:
- Diarrhea.
- Fever.
- Sneezing.
- Runny nose.
- Goosebumps.
- Sweating.
- Shivering.
- Physical tremors.
- Tingling or numbness, especially in the extremities.
- Nausea and vomiting.
- Abdominal cramps.
- Appetite changes.
- Rapid heart rate.
- Pain.
- Anxiety.
- Insomnia.
- Cravings for Suboxone.
- Obsession with acquiring more Suboxone.
- Hallucinations.
Like withdrawing from other opioid drugs, Suboxone withdrawal is not life-threatening, but it can be uncomfortable. It also lasts longer than other types of opioid withdrawal because of buprenorphine’s long half-life. Withdrawal symptoms can last at least two weeks, with the potential to linger for a month or longer.
During supervised medical detox, physicians can oversee a tapering regimen and manage severe withdrawal symptoms. For individuals who go off Suboxone completely and experience withdrawal symptoms, a doctor can also use over-the-counter drugs to ease pain, nausea, and flu-like symptoms.
Treating Suboxone Addiction
Suboxone addiction is treatable. Treatment plans typically detoxification and rehab that combines various evidence-based therapies.
Because Suboxone was intended to help people ease off other opioids, doctors can use established tapering methods to lessen the risk of withdrawal. It is not a good idea to stop taking the drug cold turkey, nor is it a good idea to attempt tapering without medical oversight.
At Recovery First Treatment Center in Hollywood, Florida, we offer multiple types of rehab for drug and alcohol addiction. These include:
To learn more about our programs, using insurance to pay for rehab, or start the admissions process, contact us at today.