SUBOXONE is a powerful prescription medication used to treat heroin dependence. Suboxone is referred to as a dual-drug, because it has two separate medications, buprenorphine and naloxone, mixed together into one medicine. SUBOXONE attaches itself to the same opioid receptors that heroin attaches to, thus producing normalizing effects, but without intoxicating the patient.
How does Suboxone work?
SUBOXONE activates opioid receptors in the brain and spinal cord just like heroin does, but with significantly less drug effects. In other words, SUBOXONE suppresses heroin withdrawal but without getting the addict high. Consequently, SUBOXONE has lead to very little misuse and very few overdoses.
The purpose of Suboxone therapy is to help men and women get off heroin, i.e. stop using heroin by transitioning the user from a condition of physical dependence to a heroin-free state. The goals of maintenance are to prevent the emergence of heroin withdrawal symptoms, suppress the patient’s cravings for heroin, shorten the timeline of heroin withdrawal and greatly lessen the drug effects of self-administered heroin in patients who episodically use heroin.
Suboxone detoxification program
Using Suboxone for heroin detoxification consists of an induction phase (first dose) and a dose-reduction phase (taper). The goal of induction is to safely suppress opiate withdrawal as rapidly as possible. Generally, during the dose-reduction phase, the more gradual the reduction, the better the outcome.
Strategies for getting off heroin with Suboxone
Fixed Dosing Schedule:
10-day Suboxone detox regimen
7-day Suboxone detox regimen
3-day Suboxone detox regimen
|Day||10-Day Detox||7-Day Detox||3-Day Detox|
|Day – 1||8mg||8mg||12mg|
|Day – 2||6mg||6mg||8mg|
|Day – 3||4mg||4mg||8mg|
|Day – 4||4mg||4mg|
|Day – 5||4mg||2mg|
|Day – 6||2mg||2mg|
|Day – 7||2mg||0mg|
|Day – 8||2mg|
|Day – 9||2mg|
|Day – 10||0mg|
Flexible dosing schedule:
7-day Suboxone detox guide
|Day||Recommended Buprenorphine Dose||Total Daily Dose|
|Day – 1||4 mg at onset, and additional 2 to 4 mg evening dose prn||4 to 8 mg|
|Day – 2||4 mg morning, additional 2 to 4 mg evening dose prn||4 to 8 mg|
|Day – 3||4 mg morning, with additional 2 mg evening dose prn||4 to 6 mg|
|Day – 4||2mg morning, 2 mg evening prn||0 to 4 mg|
|Day – 5||2 mg prn||0 to 2 mg|
|Day – 6||No dose|
|Day – 7||No dose|
Post heroin-detox treatment
In order to facilitate effective after-detox treatment, patients should be encouraged to consider further treatment services to help them sustain abstinence. Having attained complete abstinence, treatment options should be discussed, including the possibility for ongoing counseling, self-help groups, drug rehab, pharmacoptherapy treatment and others.
SUBOXONE risks include but are not limited to opioid dependency, hyperalgesia (increased sensitivity to pain) and respiratory failure (overdose). In contrast to full-agonist opioids, SUBOXONE overdose (by itself) does not appear to cause lethal respiratory failure in healthy individuals. There have been case reports of deaths apparently associated with injections of buprenorphine, which is SUBOXONE’s primary active ingredient, combined with benzodiazepines and/or other central nervous system (CNS) depressants.
Suboxone health complications
The primary health complications of SUBOXONE are similar to other opioid agonists (e.g., nausea, vomiting, constipation), but the intensity of these side effects may be less than that produced by full agonist opioids.
There is a small minority of drug users who will abuse just about any medication, but heroin addicts typically switch back to heroin as opposed to abusing SUBOXONE because SUBOXONE intoxication is much less and because it blocks heroin and other opioids for days.
Get more Suboxone information?
- Go to the Suboxone manufacturer webpage (www.suboxone.com)
A Treatment Improvement Protocol TIP 40
Treatment Improvement Protocols (TIPs) are best-practice guidelines for the treatment of substance use disorders, provided as a service of the Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT).
The approach and attitude of the physician during patient evaluation are of paramount importance. Patients are often hesitant or reluctant to disclose their drug use. Patients who are drug addicted report feeling discomfit, shame, fear, distrust, hopelessness, and the desire to continue using drugs as common reasons they do not discuss drug addiction openly with their doctors.