Suboxone is popularly known as a compound brand-named FDA approved prescription medication used to treat people addicted to opioids. It is a combination of two major component ingredients which are buprenorphine and naloxone. Buprenorphine acts an opioid antagonist, that partly inhibits the opiate receptors and curbs the addict's cravings while naloxone acts to discourage misusage, decrease diversion, and possible misuse. The combination of both agents help addiction sufferers cope with and manage withdrawal symptoms that come with the treatment. Suboxone can be prescribed by any doctor at the startup of the treatment plan and can continue well up to full recovery.
When it comes to this kind of treatment, patients are generally faced with a mirage of concerns as to the scope of the treatment, how and in what ways to begin the treatment, the type of dosage, the side effects and generally what to expect along the full medication process.
This article is tailored towards addressing these concerns posed by the patients and endeavors to make the patients as informed and comfortable as possible for the procedure.
Key Points To Consider Before Commencing The Suboxone Treatment
Before beginning any form of Suboxone treatment, it is important that the patient be provided with vital information which will be taken into full cognizance by the doctor in preparing a proper and comprehensive treatment plan. This information will include:
1. When was the last time the patient used the substance
2. The type and degree of opioid used (Long or short term prevalent)
Long term opioids like methadone will need a slower tapering before any kind of treatment than that of the short term. Treatment typically can begin in 12 hours since last time use of short-term drugs by the addict and what patient start to feeling symptoms of withdrawal.
3. Level of dependence on the opioid
All this information will play a key role in laying the path to effective opioid withdrawal and recovery.
What The Patient Should Expect Upon Starting Up The Suboxone Treatment
Intending patients who are thinking of enrolling in the program are often curious about what to expect upon starting up this treatment, the routines involved and the basic requirements for each milestone during the medication process.
The Suboxone treatment is typically divided into three phases: the beginning phase, the maintenance phase and the conclusion phase (counselling and therapy). Each phase sequentially follows up the other in a timely fashion.
The Beginning Phase:
Upon commencing treatment in the beginning phase, the first two days are dedicated to an induction into the program. During this time, patients are required not to involve themselves in any kind of outside activity to avoid derailing from the program’s course of action.
Ideally, such a patient will need to check into the medical facility for this short period for a complete mental and psychological immersion into the program. For frequently doctors are prescribing and inducing patient out-patient in the comfort of an office setting. They will then be administered with a 2 to 4 mg dose of suboxone in a tablet or film form under medical supervision to monitor for side effects, after which they can be released and free to go home from where they can continue an outpatient treatment. Subsequently after the first day of induction, additional dosages of up to 8mg could be administrated, dependent on how each patient reacts to the first dosage.
The Maintenance Phase
The maintenance phase comes up just after the induction phase. By this time, it is expected that the patient will gradually be weaned off his/her opioid dependence. This phase commences by the third day after beginning treatment. Subsequent dosages can be added or reduced, all dependent on the response and tolerance level of each patient as there really is not one strict rule of thumb to how the Suboxone medication can be administered. After the patient has achieved optimal stability upon few more doses, a dosage of 4 to 24mg will then be required daily under supervision from the medical team.
Typically, an average dose of 16mg is required daily in this phase. Patients are to keep a strict compliance on taking the prescription each day and are also required to always keep appointments with their doctors and counselling and support team.
Counselling And Therapy
Counselling is the last phase of the Suboxone treatment plan. By this time, it is expected that the main battle has been won, which sets the toll for a swift recovery process. A therapy and support session will then be arranged in this phase to help unravel what caused the patient to become opioid dependent in the first place. This phase also comes with its challenges. Upon stoppage of the medication, patients will experience withdrawal symptoms, although not as serious as those that accompany opioid withdrawal. This is where the therapy session also comes to play in helping patients manage themselves in times of crisis, help them grow and become increasingly self-aware, putting such persons on the fast track to emotional stability to avoid relapses.
Some Side Effects of Suboxone
This is another main area of concern for an average patient. The process of withdrawal from any kind of hard drug can be a very overwhelming and excruciating experience. Fortunately, this is where the Suboxone steps in to minimize the numerous side effects that come with the treatment. Patients need not worry much about the side effects of this treatment as the compound reaction of both the buprenorphine and naloxone agents helps keep them to a bearable minimum.
Some side effects typically associated with Suboxone are:
These side effects when unbearable, might cause the patient to want to withdraw abruptly from the treatment, which is very wrong and can have serious consequences such as:
Painful muscle Spasms
Should a patient wish to discontinue treatment, he or she should first contact the doctor to arrange a best plan that will guide the withdrawal process.
Battling addiction can feel like the end of the world at first, but through consistency, an excellent treatment plan by a good healthcare provider and a solid support group, patients can learn to defeat it. It is also vital to the whole treatment process that the patient keeps a personal record of his or her recovery process and is able to address any worries concerning the treatment with the doctor.
What happens at my first visit?
After the necessary patient history is documented, a urine sample is taken. After which, the patient is set up with a medical personnel. Within minutes, a comprehensive course of treatment is decided upon by both parties and induction follows immediately the following day or so.
How often do I need to have appointments with the doctor?
The induction phase would typically require a strict supervision by the doctor in charge. Subsequent treatment will require regular appointments with the doctor, say once or twice a week to once in two weeks depending on the patient. Once on a stable dose appointment can typically be set up monthly.
How long is the Suboxone treatment?
There is not one agreeable time frame for a Suboxone treatment, but the greatest successes of the program have been recorded in about a year of treatment. A year of gradual treatment will help the patient regain motor skills and build up personality that was lost. Withdrawal from the medication will also take some time for the patient to be completely weaned off it.
Does the treatment not mean swapping one addiction for another?
No. There are no tradeoffs. The buprenorphine acts an opioid antagonist, that partly inhibits the opiate receptors and curbs the addict's urges. Buprenorphine helps patients put their lives back in check and with constant therapy and counseling, are they then able to stop the usage of Suboxone completely.
Why do I need to go for counseling?
Counseling helps patients manage themselves in times of crisis, help the patient grow emotionally, become increasingly self-aware and learn to deal with problems in the lives maturely without having to be dependent on any form of medication, putting such persons on the fast track to emotional stability to avoid future relapses.
For more information about Suboxone or to make an appoinment, reach out to us today at and schedule an appointment or call 561-460-1885.
Written by: Justin Nepa, D.O.
Board Certified Psychiatrist
MorMindful Therapy & Psychiatry