Suboxone is a drug that can be used as treatment for opiate addiction. The only other treatment available besides Suboxone in the U.S. is methadone. Methadone causes patients to actually get a "high" from it, but Suboxone has nalaxone in it, which is an opiate antagonist, which causes the patient to not receive such a large high from taking the prescription drug, and also to prevent anyone from dissolving the pill and injecting it, as this would cause immediate withdrawals. The euphoria produced is very small. Also, due to nalaxone's properties, if a patient tries to use an opiate while taking Suboxone, they will not feel it at all due to the antagonistic properties in nalaxone. It typically takes 3 days to get Suboxone (and the nalaxone) out of the system of a patient taking it. Some patients go off their medication so they can start using their drug of choice again.
The active ingredient in Suboxone is buprenorphine. The nalaxone is added to Suboxone because buprenorphine is a partial opiate agonist, which basically means that it tickles (as I would say) or attaches to the opiate receptors in the brain to make the patient not ill from withdrawing from heroin, or other opiate addictions (like OxyContin, Dilaudid, Morphine). Basically, it makes the patient functional in society, and quenches cravings for opiates without causing the patient to not be addicted to Suboxone. Methadone is addictive, and some say that the withdrawals from methadone are worse from that of heroin. Suboxone is a non-addictive way of getting opiate addicted people away from their addiction.
Suboxone is taken sublingually and is absorbed through the mucous membranes in the mouth underneath the tongue. This method of taking the medication allows the buprenorphine to be absorbed fully, and a minimal amount of nalaxone to be absorbed.
To properly take the medication, it works best if the patient lays down, supresses the Suboxone under the tongue by using the tip of the tongue to put pressure on the orange tablet to dissolve and hold it in place. It is not meant to be swallowed. The taste of the medication is sort of bitter and orangey flavored.
A little History
Suboxone is the first opioid medication approved for treatment of opioid dependence in an "office based" setting. It is made to be dispensed for take-home use, and can be picked up at pharmacies when the patient has proven that they are stable enough to not have to see the doctor. Depending on the doctor, they may want to see the patient very often in the beginning of prescribing Suboxone, to monitor possible continuing drug abuse. A standard urine test is used to monitor this.
Methadone differs, as it is often times dispensed daily via Methadone Clinics. There are situations where patients on methadone are given "take-homes", but it is not very often.
Usually pain management doctors are the specialists who can prescribe Suboxone. They have to receive a certificate from the DEA to prescribe and treat patients with Suboxone. I know that the doctor in our area (there is only 1 doctor who can dispense methadone or Suboxone where I live) is limited to only have 30 patients at a time on methadone, and 100 patients on Suboxone. He has at least 6 people currently on his waiting list for methadone, but his Suboxone patient limit is nowhere near filled. A lot of addicts prefer something that will give them a bit of a high, compared to something that won't.
In order for a patient to go into treatment for Suboxone they must be an active using opiate addict. One cannot walk into a doctor's office and get this medication without being 'dirty'. They must have a urine test to prove that they have a substantial enough dose of opiates in them to receive this medication, and a long enough medical record of failed attempts at recovering from the opiate addiction. Ultimately, the decision to put a patient on Suboxone is the treating doctor's decision. Counseling is also required for patients on Suboxone. Often, seeing a drug counselor affiliated with the proper doctor before seeing the doctor, will greatly increase your chances of getting in the Suboxone program. The counselor will often vouch for the patient and validate their situation.
What happens to a person who is not an opiate addict who takes Suboxone?
(which is illegal, by the way)
If the person takes a whole 8mg pill sublingually, they will usually experience a significant euphoria at first, followed by prolonged sweating, vomiting and stomach cramps for up to 24 hours. Not a cool thing to do, doesn't sound fun does it? On the internet, something was posted about snorting Suboxone, as it is supposedly easier for a non-opiate addict to abuse suboxone without experiencing the above mentioned side effects. This is possible, however, a much smaller amount is required, 1/8th of an 8mg pill would work for someone who has experimented with opiates but never had a MAJOR habit (by that I mean, the non-majorly addicted person has never needed to seek treatment because it was ruining their life).
Sources:
- http://www.suboxone.com
- My brother-in-law who is on this medication because he has been a heroin addict about 1/2 his lifetime.