The Drug That Could Combat the Heroin Epidemic
On the other end of the spectrum of opioid agonist drugs like methadone and buprenorphine are the opioid antagonists, including the drug naloxone. In addition to being able to inhibit the activation of opioid receptors, naloxone acts as a competitive antagonist and is able to actively reverse the narcotic effects of many full opioid agonist drugs. It is this ability that makes naloxone such an important medication in treating opioid overdoses and saving lives.
Naloxone’s utility extends beyond its role as an “antidote” to opioid overdose. It is often found in a combination formulation with buprenorphine (e.g., as the opioid dependence treatment medication Suboxone—a drug which the Washington Post describes as “the drug [that] could combat the heroin epidemic.”) Its inclusion in such a treatment is done to deter abuse of the treatment drug itself. People attempting to misuse Suboxone via various routes may not only experience a blocking of the desired opioid effects, but may additionally experience immediate opioid withdrawal.
What is Suboxone?
Suboxone is the brand name for a prescription medication used in treating those addicted to opioids, illegal or prescription. It contains the ingredients buprenorphine and naloxone. Buprenorphine, a partial opioid agonist, blocks the opiate receptors and reduces a person’s urges.
Suboxone helps opioid-addicted patients find relief from opioid withdrawal symptoms. Additionally, it also helps to reduce cravings from highly addictive drugs like heroin and oxycodone. This is why doctors use it as a replacement for stronger opioids. On the other hand, Naloxone is an opioid receptor antagonist. Consequently, it inhibits the effects of opioids on the brain. The United States Food and Drug Administration (US FDA) allows doctors to use it in the following types of treatments:
Induction Therapy for Addiction: This is one of the drug addiction treatment methods aimed at rapid detox of the drug from the body. Consequently, medical detox uses Suboxone to reduce withdrawal symptoms safely.
For Methadone Addiction: The role of Suboxone in treating addicts of Methadone or other long-acting opioids hasn’t been extensively studied. Therefore, doctors do not recommend its use in such cases. Instead, Buprenorphine alone is the choice of treatment. A doctor may prescribe Suboxone after completing induction therapy.
For Heroin Addiction: Heroin or other short-acting opioids addicts should begin treatment not later than 6 hours after the last dose or when the withdrawal symptoms become noticeable.
Maintenance Therapy for Addiction: The doctor may use it as a part of maintenance therapy. This can happen once induction therapy is over and the patient has been stabilized. Suboxone aims to reduce drug cravings and prevent withdrawal symptoms from coming back.
This drug acts in a dual manner – to avoid cravings and opioid withdrawal. Therefore, the basic idea behind combining the two oppositely acting medications in a single formulation is to maintain a constant supply of the weaker opioid drug, buprenorphine, to trick the brain. This helps to reduce cravings and withdrawal symptoms. On the other hand, Naloxone limits the effects of opioids and is thus prescribed to prevent or even reverse a number of opioid-induced symptoms, such as drowsiness, respiratory depression, and loss of consciousness.
All similar drugs to Suboxone are part of what’s called a “Medication Assisted Treatment” regimen. The idea is to put the recovering addiction on a strictly monitored and controlled substance to slowly reduce and eliminate the patient’s addiction problem.
Is Suboxone Addictive?
Yes, Suboxone is addictive. Since it contains an opioid, albeit a weaker one, it has the potential of causing dependence. However, the potential is comparatively lower than that of other, more powerful opioids. It can cause feelings of euphoria and relaxation, so a person faces a risk when they get “high on Suboxone”. In this case, the brain starts enjoying the high, and one needs increasingly higher doses at regular intervals to achieve the same effect. If the doses aren’t reduced early on, the abuse may turn into full-fledged addiction. Suboxone’s addictive properties are owed to buprenorphine, its other active component. Notwithstanding the addiction potential, the benefits often outweigh the potential risks of severe addiction as it helps recovering addicts stop using far more harmful drugs.
Still, it shows promise that indeed coule be the drug that could combat the Heroin epidemic.
Avoiding Opioid Addiction: Safe Use of Suboxone
Suboxone can be administered in a controlled setting to make sure abuse of the treatment medication does not occur. Often, this is achieved in one of the following ways:
- Daily administration of the medication while living in a residential treatment facility. In such a facility, Suboxone and other drugs should be kept under lock and key so patients do not attain unwarranted access to them.
- Distribution to patients of an outpatient center. Hospitals, drugstores, and rehab facilities distribute daily doses of Suboxone to individuals who need it to make sure they don’t receive more (or less) of the drug than they need.
- If Suboxone has been prescribed to a minor, a family member may be entrusted with monitoring the drug supply and providing the needed doses in some cases.
Managing Addiction without Medication
For most people in recovery, the use of Suboxone is temporary. Use of the medication will eventually be tapered to make way for total sobriety. This process should be done in a slow and measured way, allowing for plateaus to accommodate the individual’s experience and stability along the way. When Suboxone becomes the object of addiction, however, and use of the medication no longer serves the person in a positive way, it becomes necessary to chart a new path to recovery that may not include the use of opioid medications of any kind. This requires the guidance of a team of substance abuse treatment professionals who are:
- Educated and experienced in substance abuse treatment
- Aware of all the issues contributing to the client’s current situation
- Dedicated to offering a comprehensive treatment plan individualized to meet the client’s needs
- Available to provide long-term support
Through comprehensive treatment that includes medical care to address detox and associated withdrawal symptoms as well as therapeutic intervention, medication may not be necessary.