Suboxone is not a cure for opiate addiction

Too many opiate addicts and helping professionals rely too much on Suboxone and not enough on addiction treatment. To be clear, Suboxone is not a cure for opiate addiction, it’s merely an aid to recovery. Suboxone will ease withdrawals from opiates, but it doesn’t address the other powerful component of addiction — the mental obsession.

Some in the addiction treatment field, and many psychologists, are reluctant to use the word “addict”, choosing instead terms like chemical dependence or use disorder. I use addict and addiction because it’s clearer. When I speak of someone as an alcoholic, cocaine addict, opiate addict, etc., I’m not judging the person or placing a negative label on them, just describing the person’s condition in relation to the drug. The person addicted shouldn’t feel ashamed, although most do. It’s way past time to think of addiction as a medical issue. Millions have died from addiction because of social stigma and shame. The stigma and shame usually prevent the addict from seeking treatment, so they look for easy, quick fixes.

Science has learned a lot about addiction in general. Opiate addiction is currently a major problem, and Suboxone has a been a great help in helping addicts come off opiates with little pain. In the 80s, when I first started in the field, opiate addicts had a low rate of recovery, mainly because the withdrawal was so painful. Now, we have medication to help with the withdrawal, but what we lack, as has always been the case, is access and referral to quality treatment. 

Too many opiate addicts are taking Suboxone with the idea that’s all they have to do, then they usually return to the heroin or oxycontin or whatever opiate form they were using. Addressing the physical dependence is the first thing that has to happen, but, then, there’s the mental obsession. The mental obsession in addiction is what confounds everyone. Addicts continue to use their drug of choice long after it has any pleasing effects. The idea that addicts are partying constantly and enjoying it, or the notion they’re using the drug to escape painful memories from past trauma, are misunderstandings of addiction. In the later stages of addiction there is no fun and the addiction creates pain (physical, emotional, mental and spiritual pain), it doesn’t ease pain.

The basic definition of addiction is the continued use of the drug despite negative consequences. So, just easing withdrawal from opiates with Suboxone is usually ineffective because the mental obsession hasn’t been addressed. Just like detoxing an alcoholic doesn’t usually create long term sobriety if detox is not followed up by some form of treatment/counseling, using Suboxone is not a cure for opiate addiction. What’s effective treating opiate addiction is short term use of Suboxone to ease withdrawals then some form of treatment followed by long term recovery management. Addiction is complex, and any easy solution that’s offered will likely fail.

A rational person looking from the outside would think that when a person is told they have an addiction problem, and after the addiction has caused so many problems, the person would then just stop using once they’re detoxed. When the person returns to the drug that’s killing them, it’s not because they are weak willed, uncaring, dumb or suicidal — it’s because the mental obsession was never treated, and the person didn’t follow up with long term recovery management.