Addiction Drug Use Opioids Treating Opiate Addiction With Suboxone Combination Drug Offers Advantages Over Methadone Therapy By Mark Cichocki, RN twitter linkedin Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years. Learn about our editorial process Mark Cichocki, RN Medically reviewed by Medically reviewed by Steven Gans, MD on March 23, 2021 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Review Board Steven Gans, MD Updated on March 23, 2021 Print Pamela Moore / Getty Images Opiate addiction is a growing problem in the U.S. as evidenced by the 2015 outbreak of HIV in Indiana, which was attributed to the injection of prescription oral painkillers. In the face of a widening epidemic, a prescription drug called Suboxone (buprenorphine + naloxone) is being increasingly used to treat opioid addiction. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Understanding Opiates Opiates are a family of narcotic drug derived from or related to the opium poppy plant (Papaver somniferum). They function as sedatives to depress activity in the central nervous system and reduce pain. Long-term opiate use can result in increased tolerance to the drug. When this happens, the user would need to increase the dose to achieve the same effect. This can cause dependence, meaning that there are withdrawal symptoms when the drug is stopped. It can also lead to a behavioral pattern where the drug continues to be used in spite of adverse consequences. This has come to be known as an addiction. In some cases, this can lead to accidental overdose and even death. Some of the most commonly abused opiates include: Heroin Fentanyl Morphine Vicodin (hydrocodone) Oxycontin Oxycodone Codeine Methadone Treating Opioid Addiction With Suboxone Suboxone is an oral prescription drug that was granted approval from the U.S. Food and Drug Administration in 2002 to treat opioid addiction. Prescribed as either a sublingual tablet or film, it contains two active drugs: Buprenorphine, a partial opioid antagonist, which provides relief from craving and withdrawal symptoms by blocking opiate receptors in the brain Naloxone, an opiate antagonist, which blocks the effects of the opiate drug itself The combined use overcomes some of the shortcomings of the individual drugs. Buprenorphine decreases withdrawal symptoms and opiate cravings without having full opiate effects. Naloxone, by contrast, works in the background as a deterrent, only taking effect if suboxone is injected into the system. When this happens, naloxone can induce withdrawal symptoms including nausea, headache, sweating, restlessness, vomiting, and trembling. Effectiveness Suboxone has been found to be effective in that it reduces the cravings associated with long-term opiate use while providing deterrence to current use. Suboxone seems to work better when used for longer periods of time. One study showed that opiate-dependent youth who used Suboxone for 12 weeks were more likely to remain abstinent compared to counterparts who had only undergone two-week detox treatment. How It's Prescribed Suboxone is prescribed as part of a structured drug detoxification program and for maintenance therapy when needed. It is available as a generic (or under the other brand names Bunavail and Zubsolve) and offered in various formulations: 12 mg buprenorphine with 3 mg naloxone 8 mg buprenorphine with 2 mg naloxone 4 mg buprenorphine with 1 mg naloxone 2 mg buprenorphine with 0.5 mg naloxone Treatment Plans While approaches can vary depending on treatment centers, there are typically four steps to any Suboxone treatment plan: Intake which includes a medical and psychosocial evaluation, a urine drug screen, and blood tests to ensure that you can take the drug without harm Induction to transition you from the opiates you are currently on to Suboxone with the aim of minimizing "cold turkey" withdrawal symptoms Stabilization where Suboxone is adjusted to the lowest dose to suppress withdrawal symptoms to allow for eventual tapering off and discontinuation of treatment Maintenance for those with severe addiction who may need on-going, medically supervised treatment and support (including attendance at a Narcotics Anonymous or non-step support group) Considerations Suboxone should be used with caution in persons with moderate to severe liver dysfunction as the can lead to a worsening of symptoms. Common side effects include headache, nausea, vomiting, excessive sweating, constipation, symptoms of withdrawal, insomnia, pain, and the accumulation of fluids in the legs (peripheral edema). Suboxone does have the potential for misuse. As such, Suboxone can only be prescribed under a doctor-supervised treatment or maintenance program. Because opioid addiction is both a physical and psychological illness, treatment requires a multidisciplinary team able to address both of those needs. If you feel you could benefit from Suboxone, contact the hospitals or mental health agencies in your area for referrals to nearby addiction treatment centers. Was this page helpful? Thanks for your feedback! Learn the best ways to manage stress and negativity in your life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Woody GE, Poole SA, Subramaniam G, et al. Extended vs short-term buprenorphine-naloxone for treatment of opioid-addicted youth: a randomized trial. JAMA. 2008;300(17). doi:10.1001/jama.2008.574 Additional Reading Reuters. "Indiana HIV outbreaks tops 100 cases: state health officials." Issued April 11, 2015. U.S. Food and Drug Administration. "Highlights of Prescribing Information: SUBOXONE (buprenorphine and naloxone) sublingual film, for sublingual or buccal use CIII." Silver Spring, Maryland; October 8, 2002; updated February 2017. 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