Suboxone, otherwise known as Buprenorphine-Naloxone, is a medication used to treat opioid dependence. It is recommended to be used as part of a comprehensive treatment plan that includes counseling and psychosocial support.

Subutex (Buprenorphine, mono-product) is partial opioid agonist that has properties to treats opioid withdrawal symptoms and cravings. Suboxone (Buprenorphine-Naloxone) is a different formulation that has an added opioid antagonist.  This formulation is the preferred treatment medication as it prevents injection diversion. This medication is used for both short-term detoxification and longer-term maintenance, commonly referred to as Medication Assisted Treatment (MAT).

Who is a good candidate for Suboxone MAT?

·      If you have opioid dependence and suffer from physical withdrawal symptoms or cravings. 

·      If you prefer a medication that you can keep at home and not have to obtain daily from a clinic, like Methadone.

·      If you are medically cleared to take Suboxone (no allergies to ingredients in the medication and no liver impairment)

·      If you are committed to a recovery program and actively participating in counseling or other supportive treatment during Suboxone treatment.

Who should avoid Suboxone? 

·      If you have allergies to the ingredients in the medication.

·      If you have severe liver disease.

·      If you currently taking high doses of opioids and are not actively experiencing withdrawal symptoms. Taking Suboxone too soon can cause precipitated withdrawal.

·      If you are taking certain medications that combined with Suboxone could cause adverse reactions

Stigma associated with Suboxone

·      “You’re trading one drug for another” – Many believe that taking Suboxone means you are not really in recovery. Suboxone stabilizes brain chemistry, reduces cravings, prevents relapse and is protective against overdose. There is a high rate of relapse in early recovery and this population is at a higher risk of overdose. 

·      “You’re still in active addiction” – Some people assume that taking prescription Suboxone means that you are still using. Suboxone is sometimes misused, but far less than full opioids and it carries a reputation by those who are unfamiliar with its medical use. 

·      Judgement from Traditional Recovery Groups –  Some 12 Step recovery groups promote complete abstinence but Suboxone has been proven as a safe, evidence-based treatment for Opioid Use Disorder. 

·      Misunderstanding by Health Care and Society– Some doctors and pharmacists treat Suboxone patients differently, assuming they are “drug-seeking”.  Family members and employers may not be educated about how Suboxone works and may view it negatively.

·      Employment Discrimination – While many Suboxone patients are protected by employment discrimination by American Disabilities Act (ADA), there are some professions that may require additional documentation and screenings.

How to Decide if Suboxone is right for you?

·      Talk to your healthcare provider or addiction specialist. It is important to weigh the risks versus the benefits.

·      Consider your goals and accessibility to treatment options. Can you attend traditional inpatient detox and utilize Naltrexone or Vivitrol (opioid antagonists)? Are you restricted to out-patient treatment due to work, financial, family or other obligations? Are you considering a short-term detox and transition from opioids or do you prefer longer term maintenance?

·      Be honest with yourself about your history and your motives. Seek support from professionals who can help you decide your best options.

Written By: Aimee Meehan, APRN, PMHNP-BC, CARN-AP