What Is Suboxone?
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Physicians have been prescribing Suboxone in the U.S. for over 15 years, and the medication has been shown to be very safe and effective in helping patients overcome their addiction to Oxycontin, Vicodin, Percocet, oxycodone and heroin.
How can taking medication cure addiction?
The answer to that question lies in the unique pharmacology of Suboxone (buprenorphine) -- It has virtually no intoxicating effect. At the same time, it partially stimulates the mu (pronounced “myou”) receptors, in the brain, and elsewhere in the body. It is these mu receptors that the opiate addict seeks to stimulate, normally with full mu agonist drugs such as Vicodin, Lorcet, Oxycontin, Dilaudid, codeine, heroin, and similar drugs.
As such, Suboxone (buprenorphine) mimics the effect of naturally produced endorphins in the body, a polypeptide associated with natural highs, such as the “runner high,” the daredevil’s high,” the high associated with orgasm, etc.
Both buprenorphine and naturally produced endorphins give one a feeling of well-being that is artificially achieved by opiate abusers using full mu agonists. While it is true the feeling of well-being achieved from buprenorphine is also artificial, it can be likened to replacing natural insulin with “artificial” insulin in a diabetic. While the diabetic can work on reducing or even eliminating his disease using natural methods such as weight loss and diet, many opiate addicts similarly need to work on their addiction’s using additional psycho-behavioral therapy.
Many opiate addicts spontaneously go into remission with buprenorphine alone without psycho-behavioral therapy.
Suboxone is best used in conjunction with addiction therapy and group counseling.
The Shortest, Most Cost-Effective Route from Opiate Dependence to Secure Abstinence
If you are not yet on a steady dose of suboxone, the first visit will be for history taking and getting to know your new doctor and counselor. We believe that the first 24 to72 hours after first starting Suboxone are critical so we would like patients to be in close proximity to our team during this time. Participants from out of town are advised to stay in a nearby hotel during this period. A list of convenient hotels in all price ranges will be provided.
For the second visit, you need to be in a moderate, 24-hour withdrawal so that we can introduce the suboxone over 2 hours in our office. We will continue to do counseling, group sessions and monitor you weekly over the next 8 weeks. Thereafter you will be tested and meet with the doctor every month while continuing weekly counseling.
Two to six months and beyond, Dr. Saltzman, in collaboration with you and the treatment team, will determine the frequency of visits during this period. It is our belief that six months is the shortest treatment time. In our experience, one to three years gives most people enough time to start learning the tools of recovery, make some changes in who they hang out with and amount of use before coming in for treatment. Of course, the most important element is that one is willing to take the next right action and come in to start the journey
Suboxone vs Methadone
For years, Methadone had been the main drug for treatment of opiate withdrawal. With the development of Suboxone, medically detox has changed dramatically. Suboxone has several advantages over methadone. First, it is much safer. If a patient uses a street drug while taking Suboxone, it’s very unlikely that they will overdose, as they can with methadone.
Methadone can be abused, so patients would need to go to a special & licensed methadone clinic each day to take their medication.
Suboxone therapy is much more discreet. At NYC Suboxone, our patients can get their prescriptions written and filled in the privacy of our office. Suboxone patients do not need to visit a clinic every single day.
Suboxone is generally less addictive than methadone.
Withdrawal symptoms of a Suboxone detox are generally less severe than methadone detox. Methadone and Suboxone are synthetic opioids. Opioids, like heroin and oxycodone, attach to specific receptors in the brain, stimulating neurotransmitters that cause euphoria and decreased pain. Suboxone and Methadone connect to these same receptors.
Technically, Methadone is a full opiate agonist and Suboxone is a partial opiate agonist. This means that Suboxone attaches very tightly to the brain’s opioid receptors. But it attaches itself imperfectly. In effect, it tricks the brain into believing it has been satisfied but does not deliver a high. And because Suboxone has attached itself so tightly to the receptors, they are blocked and cannot receive other opioids.
Suboxone and Pregnancy
Expecting mothers want the best for their babies. So it is not uncommon for a woman, addicted to a painkiller or other drug, to desire to become clear - to end their addiction.
At NYC Suboxone we work with pregnant women who want to get off painkillers or heroin. A form of suboxone called Subutex can be used while pregnant. Children born while mothers are on Suboxone generally do not experience withdrawal symptoms when they are born. The opposite is also true - a child born to an addicted mother will likely go through "withdrawal" from the drug the mother after they are born.
From Village Voice: October 23, 2013:
"Dr. Saltzman has seen the rise of Suboxone abuse firsthand. She has had a license to prescribe it since 2000. In the past few years the number of patients who suspects are diverting the drug is increasing."
'There's a constant wave of diversionary tactics in here', she says. 'It's constant and unending. It's just piling up.'
"She tries to weed out the drug seekers from the people who are genuinely eager to get sober. She requires patients to attend group therapy and one-on-one sessions with a counselor, and she encourages them to enroll in a 12-step program like Narcotics Anonymous."