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Alternatives To Suboxone Use In Mat
Suboxone has few alternatives in the way of medication-assisted treatment, with methadone being the primary competitor. Methadone is a full opioid agonist, meaning it has a greater potential for abuse than Suboxone. Both medications block the effect of other opioids by filling the opioid receptors in the brain, and both medications will assist in the treatment of opioid withdrawal symptoms.
Methadone, however, must be administered in a doctors office or via a specialized methadone clinic, making it harder on some individuals to opt for this regular commitment. Buprenorphine-based medications, like Suboxone, give users more flexibility.
Some holistic treatment programs shy away from any medication assistance.
Those with short-term or less severe addictions to opiates may be able to forego the use of medication-assisted treatment however, its imperative that they only do so under direct medical supervision.
In the majority of instances, medications may be employed during opiate detox.
Find out if Suboxone treatment and rehab may be covered by insurance.
There are a wide variety of therapies that can be used in addition to medication-assisted treatment, including self-help groups, behavioral therapies, alternative treatments, and more. Treatment programs should be specialized for each individual, depending on the particular circumstances in question. For some, Suboxone may not be an appropriate treatment.
Warning Disclaimer Use For Publication
WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.
If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.
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Suboxone And Herbs And Supplements
Suboxone can interact with certain supplements or herbs you may be taking.
Herbs and supplements that affect serotonin
Supplements that affect serotonin levels can increase your risk of developing serotonin syndrome.
Examples of these supplements include:
- 5-HTP
- valerian
St. Johns wort
St. Johns wort can make an enzyme called cytochrome P450 3A4 more active in your body. Because of this, taking St. Johns wort with Suboxone can cause your body to get rid of Suboxone more quickly. This can make Suboxone less effective.
The Truth About Opiate Addictions
The truth is that opiate addicts are often times looked at as being unable to recover by many within the medical field. The relapse rate for opiate addicts is extremely high and the rate of overdose and death is much higher than any other drug in the addiction treatment field. Often opiate addicts that go to treatment and achieve some time away from their drug of choice end up using opiates again when they relapse and because of a decreased tolerance end up using too much and overdosing. Many of them die. Because of this, opiate replacement therapy like Suboxone and methadone maintenance is often used by doctors and some treatment centers as a model known as harm reduction.
This means that these entities dont necessarily look at an opiate patient as someone that can ever achieve real abstinence or sobriety, but rather as a number that they are trying no to add as an overdose statistic. Like, this kid can never get clean so at least lets try to keep them from killing themselves from an overdose. This seems like an excellent theory, but there are two main problems:
Drug Forms And Strengths
Suboxone is only available as an oral film that can be placed under the tongue or in the cheek . It comes in four strengths:
- 2 mg buprenorphine / 0.5 mg naloxone
- 4 mg buprenorphine / 1 mg naloxone
- 8 mg buprenorphine / 2 mg naloxone
- 12 mg buprenorphine / 3 mg naloxone
Suboxone is also available as a generic version that comes in other forms. These forms include a sublingual film and a sublingual tablet.
Other drug forms
Suboxone contains two drugs: buprenorphine and naloxone. These individual drugs come in additional forms. Buprenorphine forms include a sublingual tablet, a skin patch, an implant for under the skin, and a solution for injection. Naloxone forms include a nasal spray and a solution for injection.
Speak To Your Doctor If You Are Interested In Learning More About Life
If you are avoiding starting Suboxone treatment because you are worried about depression and other opioid withdrawal symptoms after you stop taking Suboxone, you should not be too concerned about this. Medication-assisted treatment is life saving and is a much safer way to quit street opioids, compared to abstinence-based treatment alone.
Withdrawal symptoms after completing therapy can be managed with help from your doctor. In weighing the risks versus benefits of Suboxone therapy, the benefits often outweigh the risks by a significant margin. Depression should not be a concern to prevent you from starting Suboxone treatment.
Subjective And Physiological Effects Of Buprenorphine
Buprenorphine slightly increased ratings of feel drug , like drug , and want more . Buprenorphine did not significantly affect ratings of feel high, or dislike drug. Buprenorphine did not exert significant effects on heart rate or blood pressure. DASS scores did not significantly predict subjective drug responses.
Mean ratings of feel drug throughout the sessions during placebo sessions and after buprenorphine . Shaded area indicates the time during which the tasks took place.
Risks Of Suboxone For Depression Treatment
However, there are a number of factors to keep in mind when it comes to the idea of using Suboxone for the treatment of clinical depression. The primary among them is that Suboxone is still a powerful drug, one that is designed to be moderately addictive , and for people suffering from depression, the feeling of tranquility and peacefulness can be dangerously attractive.
Additionally, every drug and medication has its own side effects and differences in how it reacts from one person to the next. There is no way to predict the power and effectiveness of a Suboxone or its long-term effects in a person who might or might not have an opioid use disorder.
Lastly, care must be taken when a patient with major depressive disorder goes without Suboxone for a while, so the withdrawal process itself is carefully monitored. The psychological effects of opioid withdrawal can be strong enough to increase the feelings of depression and compel a deeper craving for the buprenorphine, notwithstanding the opioid antagonist naloxone being part of the medication.
Opioid Receptors And Depression What Is The Buprenorphine Kappa Connection
We often imagine that opioid receptors are all the same in the human body. Opioids travel to the brain and bind to these receptors, causing various effects. This is an oversimplification. There are actually several different kinds of opioid receptor.
Buprenophrine works on three different kinds of opioid receptor. It is a partial agonist at the mu receptor and an antagonist at the kappa and delta receptor. When it comes to depression, the kappa opioid receptor is where things get interesting.
It turns out that blocking the kappa receptor has a positive effect on depression. Drugs that are kappa opioid receptor antagonists tend to have an antidepressant effect. Suboxone contains buprenorphine, which is such a drug, blocking the kappa receptor.
Weighing The Pros And Cons Is Always Important When It Comes To Making Important Treatment Decisions
If, after stopping Suboxone, you begin to experience addictive thoughts and feelings, such as cravings for opioids, it may mean that you will do best to resume treatment for a longer period of time.
Going back on Suboxone does not mean failure. Avoiding a dangerous relapse on opioids by resuming treatment is a huge success. Often, when a patient does resume Suboxone treatment, they are able to take a lower dosage than what they were taking previously.
Using Suboxone For Opioid Addiction
As an opioid treatment, Suboxone works very well. Its first clinical study found that it substantially improved the outcomes of 154 people aged 15-21, who were addicted to opioids for at least 1.5 years, located across the United States. Researchers noted that Suboxone not only reduced the consumption of opioids, it was also associated with a decline in other forms of drug use. Additionally, Suboxone therapy led to patients retaining the concepts of their therapy and rehabilitation better compared to the group that received therapy without Suboxone.
The clinical study was conducted in 2008, and four years later, there were 9.3 million prescriptions for Suboxone filed in the US.
Suboxone And Depression Should Not Be A Concern When Considering Starting Suboxone
As I have discussed here, there is little to no concern about depression caused directly by Suboxone. The main drug in Suboxone, buprenorphine, has properties to improve symptoms of depression. Additionally, Suboxone contains naloxone, an opioid blocking drug.
While very little of the naloxone is absorbed into the patients system, we should consider the possibility that the small amounts of this powerful opioid blocker that do enter the patients central nervous system might have an effect similar to LDN.
More research will be necessary to assess if Suboxone helps more with depression and other conditions compared to buprenorphine alone, due to the addition of naloxone. The reason naloxone is included in the Suboxone formulation is as an abuse deterrent, to deter patients from shooting up their Suboxone with a syringe and needle. It would be interesting to discover that there are also therapeutic benefits to having naloxone in the mix.
Buprenorphine Improved Resistant Depression Outcomes
the Psychiatry Advisor take:
Buprenorphine, a medication used in the treatment of opioid addiction, may also benefit patients with treatment-resistant depression, who have not responded to antidepressants, researchers found.
Jordan F. Karp, MD, of the University of Pittsburgh School of Medicine in Pennsylvania, and colleagues assessed whether buprenorphine improved symptoms in 50 patients with treatment-resistant depression during an eight-week period.
Changes in depression, anxiety, sleep, positive and negative effect, and quality of life were assessed. The Montgomery-Asberg Depression Rating Scale served as the main outcome measure.
Mean depression score at baseline was 27.0 versus 9.5 at week eight. A sharp decline in depression severity occurred during the first three weeks of buprenorphine exposure , the researchers reported in the Journal of Clinical Psychiatry.
In addition, depression-specific items measuring pessimism and sadness indicated improvement during exposure, supporting a true antidepressant effect. Also, executive function and learning improved during treatment.
Low-dose buprenorphine may be a novel-mechanism medication that provides a rapid and sustained improvement for older adults with TRD, the researchers concluded.
Concurrent Use Of Suboxone And Benzos
Concurrent use of Suboxone and benzos is common despite the risks involved. In a study published in Addiction, approximately two-thirds of people who reported buprenorphine use also used benzos. This is concerning, as the two drugs interact with one another very poorly, and this can present a hazardous situation for a user. According to the FDA, mixing certain opioid medications and benzos can result in coma and death. This is why the organization began requiring strong warning labels on related medications in 2016.
Benzos are considered to have a high potential for abuse, putting those with substance abuse issues at serious risk even if they are given a legitimate prescription for the medication. Those who are prescribed Suboxone have obviously had trouble with substance abuse, as the drug is used to treat opioid addiction. This means that someone taking Suboxone would be more at risk to abuse benzos than someone who has not been prescribed the drug simply due to their addiction history.
Mixing these two drugs can result in an extreme state of sedation.
Excessive sleepiness is not uncommon when benzos and Suboxone are combined, and users may be at serious risk for respiratory depression and low blood pressure. As referenced earlier, coma and death are the most significant consequences that can arise when these two substances are mixed.
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Rated For Depression Report
I tried around 20 medications for depression at the same time I was addicted to opiates none of the 20 medications helped my depression when i started taking suboxone for my opiate addiction I started noticing my depression got much better it really gave me the first relief I had from depression in many years 6 years later I am still taking it I also have pain it helps that too this drug saved my life please try this if you have treatment resistant depression it will be a decision that will change your life with the only side effects of constipation I also have zero cravings for pain medicine but I really cannot stress enough how well this works for depression I would not be here right now without this drug ????
Rated For Opioids Dependency / Withdrawal Report
Ive been on suboxone for two years straight and before that off and on for a couple years. Suboxone has changed my life. It lets me live normally like normal people. My brain isnt normal as an addict and suboxone levels the playing field for me. It stops my anxiety. Depression. Makes me happy and drug free. Not living chasing a high. The only side effect for long days I can feel my medication wearing off at the end of the day and can feel the depression and anxiety coming in. Just dose correctly and this drug can save you too.
Does Suboxone Use Lead To Tolerance
When certain opioids are used long-term for treating pain or for a high, tolerance to those effects can happen over time. This means your body gets used to the drug and you need higher and higher doses to get the same effect.
Drug tolerance has not been seen with Suboxone or with either of the drugs it contains . When Suboxone is used long-term for opioid dependence, tolerance to the beneficial effects of Suboxone doesnt occur.
While taking Suboxone for opioid dependence, you may be required to do frequent drug tests for the use of opioids.
Is Suboxone A Controlled Substance
Yes, Suboxone is a controlled substance. Its classified as a schedule three prescription drug. This means that it has an accepted medical use, but it may cause physical or psychological dependence and may be abused.
The government has created special rules for how schedule III drugs can be prescribed by a doctor and dispensed by a pharmacist. Your doctor or pharmacist can tell you more.
Doctors can only prescribe this drug for opioid dependence after receiving special training and certification through the U.S. federal government.
Abuse Of Suboxone And Xanax Is Dangerous
Using these two medications as prescribed in combination poses some risks. However, abusing either drug in excessive amounts is much more likely to lead to severe complications and overdose. The greatest threat to any person who uses these drugs is respiratory arrest, which is more likely to occur when different CNS depressants are used in conjunction.
Benzos like Xanax may be abused in this situation because the abuse of Suboxone can result in adverse effects that can prompt immediate withdrawal symptoms. Buprenorphine itself is considered to have a relatively low potential for abuse, and with the addition of naloxone, its potential decreases even further. Conversely, Xanax is a prevalent drug of abuse, but if it is abused independently of other substances, it is unlikely to be lethal.
For this reason, individuals who use Suboxone and Xanax may not realize that there may be dire consequences of doing so. Overdose notwithstanding, combined abuse also places a person at a higher risk of experiencing adverse health consequences in both the short- and long-term.
Concurrent use of these two substances has also been found to reduce the likelihood that the person in recovery from another substance, such as heroin, will sustain long-lasting sobriety. Also, if an individual continues to abuse Xanax after Suboxone has been stopped, this in and of itself can contribute to a relapse.
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Rated For Opiate Dependence Report
I am a 46 y/o female with a history of Multiple Sclerosis. I also have DDD and have lived with severe pain in my lower back and legs that was not responding to traditional opioid therapy. I had lost so much mobility, I felt that my once very active life was being lived in a recliner. Pain consumed my life. Recently I was prescribed Suboxone for pain management. It has been a lifesaver!! I have been given my life back… and I couldnt be happier. I went from a 7 on the pain scale daily… to a 1. This medication also has helped with the parasthesias in my legs . I am so grateful for this medication and the physician who prescribed it for me.
Allergy Cold And Flu Medications
Many allergy, cold, and flu medications contain acetaminophen or alcohol. Mixing any alcohol with Suboxone is extremely dangerous. Mixing acetaminophen with Suboxone may cause liver damage. It is best that you do not take allergy, cold, or flu medications when you are on Suboxone, unless your usage is strictly supervised.
Suboxone And Other Medications
Below is a list of medications that can interact with Suboxone. This list does not contain all drugs that may interact with Suboxone.
Before taking Suboxone, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Benzodiazepines
Taking Suboxone with benzodiazepines can increase the risk of severe side effects such as severe sedation , breathing problems, coma, and death.
Examples of benzodiazepines include:
- rifampin
Serotonergic drugs
Taking Suboxone with medications that increase serotonin levels in your body might increase your risk of developing serotonin syndrome, a drug reaction that can be dangerous.
Examples of medications that increase serotonin levels include:
- antidepressants, such as:
- selective serotonin reuptake inhibitors such as fluoxetine , paroxetine , and sertraline
- serotonin-norepinephrine reuptake inhibitors such as duloxetine and venlafaxine
- tricyclic antidepressants such as amitriptyline, desipramine , and imipramine
- monoamine oxidase inhibitors such as phenelzine and selegiline