Suboxone: Detox or Maintenance?

Suboxone: Detox or Maintenance? First, here is a description of Suboxone/Buprenorphine from sources such as USDA:

Buprenorphine

Prescription drug

Consult a doctor if you have a medical concern.

Treats moderate to severe chronic pain. This medicine is a narcotic analgesic.

• Transdermal: Side effects – Warnings – How to use

  By mouth: Side effects – Warnings – How to use

  Injection: Side effects – Warnings – How to use

  National Library of Medicine

• Brand names: Butrans, Buprenex

• Legal status: Schedule III controlled substance

• Pregnancy risk: Category C (Risk cannot be ruled out)

• Possible side effects: Constipation, Headache, Vomiting, Perspiration, Abdominal pain

• May treat: Pain, Opioid addiction and dependence

• Drug classes: Analgesic, Partial Opioid Agonist

So, Suboxone treats chronic pain, and it’s also used to treat Opioid addiction. Suboxone is a good detox for opioid addiction because it doesn’t create the euphoric effect, but it stops the craving for opioids like oxycodone or heroin. Used as a short-term detox medicine, Suboxone is highly effective. Whether or not Suboxone is a good maintenance drug for the long term treatment of opioid addiction, well, here there is controversy.

There’s some indication that Suboxone is good long term maintenance for opiate addicts who have been addicted for a long time with very heavy use. It’s better to take Suboxone because a person can function on Suboxone, whereas the heroin addict loses the ability to function normally. The reason Suboxone would be used for long term treatment maintenance is because a severe opiate addict has done a lot of damage to their brain, and it’s almost impossible for the serious opiate addict to stay clean without a lot of help. Counseling and Suboxone maintenance show more success than previous treatment modalities for serious opiate addiction.

The problem is that Suboxone is addictive — it’s basically an opiate drug, although it acts differently on the brain than an opiate like heroin. It’s also not like Methadone. Methadone can make a person “high”, but Suboxone doesn’t have that euphoric effect after a couple of days, and Suboxone contains another drug, Naloxone, that neutralizes the effects of opiates like heroin, so if the person on Suboxone maintenance used heroin, the heroin would have no effect.

So, the controversy continues. Some healthcare professionals believe that opiate addiction shouldn’t ne treated with an opiate drug, but they have to show better results with other methods before their protestations have merit. If Suboxone is managed by a physician with understanding of addiction, and if the opiate addict is receiving addiction counseling and treatment, and if the Suboxone use is limited to an end date, and if the Suboxone is gradually reduced to meet the end date, then an opiate addict, who before had a slim chance at recovery, now has a much greater chance of becoming drug free and a changed person.