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Suboxone (Buprenorphine) Alternatives, Side Effects, Withdrawal and FAQs

Suboxone and Subutex are brand names for the generic opiate buprenorphine, used in MAT (medication assisted treatment). Since FDA approval in 2000, Suboxone has been used along with counseling and social support programs for opiate addiction treatment.

Suboxone can decrease the pain and lessen intensity of cravings in opiate withdrawal management.
Suboxone has been available for use in opiate withdrawal programs since the FDA approved the drug in 2000.

Suboxone is dispensed in clinics and doctors’ offices and comes in a sublingual film or tablet, or can be given in I-V treatment. Suboxone allows for conversion from heroin or other opiates without dramatic or painful withdrawals. Buprenorphine, the generic drug, is a partial agonist, which means that it produces some of the characteristics of other opiates such as euphoria and lowered respiration, but to a much lesser extent than heroin or methadone.

The FDA has recently approved a new generic product that combines Suboxone with Naloxone in a sublingual film form, which has been designed to block the high or euphoria, but still significantly dampen uncomfortable withdrawal symptoms and cravings.

There is information available to help in understanding the best use of Suboxone and some of the risks to avoid, if you are considering starting or stopping Suboxone.

What Is Suboxone Used for?

According to US government statistics, approximately 130 people die each day from opioid abuse.

Suboxone is primarily used as a withdrawal management tool, as part of a more comprehensive treatment program for opiate addictions. Sometimes Suboxone is prescribed for a long-term “maintenance” strategy for opiate cessation. However, when used as a bridge medication, Suboxone is easier to taper from than other opiates.

There is a “ceiling effect” that accompanies daily use of Suboxone, where the euphoric opioid effects initially increase with each daily dose, until these effects level off, even if the dose is increased. This is thought to help reduce the risk of Suboxone abuse.

Suboxone Alternative Names and Slang

Suboxone has acquired a number of street or slang names, such as Sobos, Sub, Stops, Box or Boxes, Oranges, and Saboxin. Buprenorphine might be called “Bupe” on the street market.

Suboxone Side Effects

Side effects while taking Suboxone are similar to other opiates, such as heroin, but are generally milder. These can include:

  • Euphoria (mild
  • Nausea
  • Vomiting
  • Constipation
  • Muscular and bone pain
  • Cramps
  • Insomnia
  • Agitation, anxiety
  • Depression, irritability
  • fever

Suboxone Withdrawal Symptoms

Coming off Suboxone should never be done cold turkey if that can be avoided. Quitting buprenorphine or any equivalent drug can create similar withdrawals to heroin or other opiates, and can include:

  • Drug cravings
  • Nausea
  • Vomiting
  • Diarrhea
  • Profuse sweating
  • Loss of appetite
  • Rashes, skin crawling, goose bumps, redness, chills, hot flashes
  • Insomnia, disturbed sleep
  • Bone or muscle pain, cramps
  • Tiredness, fatigue, weakness
  • Depression
  • Anxiety
  • Mood changes, irritability, anger, hopelessness, crying

Discontinuing/Quitting Suboxone

Quitting Suboxone is hardly ever discussed in medical literature. The drug has been more or less grouped in with other MAT methods, often involving years of continued drug use. This is not always necessary and is often not the most desired outcome of addiction treatment.

Using effective techniques, Suboxone can be used as a bridge medication for quitting other opiate drugs, but the person does not have to be left with ongoing use of an opiate drug to get sober and stay clean.

The following information covers various options for quitting opiates, including Suboxone, Subutex, or Methadone, removing the need for long time use as the means to reach your sobriety goals.

For clients who are I-V heroin users, or those involved in heavy opioid medication abuse, Suboxone has the advantage of helping a person transition from harmful abuse patterns to a more sustainable way of life. For an abuser, relapse brings the very real possibility of death by overdose. This is, at least in part, because tolerance to opiates will decrease with abstinence. What Suboxone can do is reduce the likelihood of relapse and thereby lower the risk of overdose and accidental death. However, there is more to understand about using Suboxone.

Persons who are craving opiates may have a biological reason for doing so. A person may be plagued by an addictive biochemistry that can actually be corrected. Natural endorphin levels can be restored through protocols designed to do this repair naturally, as well as implementing lifestyle changes that support recovery. The goal is to accomplish this correction with a minimum of pain or discomfort. Holistic methods have come a long way in providing treatment that can effectively reduce pain and discomfort, both physical and emotional, during recovery. If these holistic methods can be adopted as new lifestyle choices, there is a stronger chance of permanent success.

It may prove difficult to adopt many new changes all at once, and if this is the case, Suboxone can provide a viable pathway in the meantime.  This may be a pragmatic choice to avoid relapse. Sooner or later there may come a time when stopping Suboxone seems a very desirable next step, and this is also a great choice.

Since Suboxone is a long-acting opioid, it can present challenges when withdrawing from the drug; after long-term Suboxone use withdrawals can be severe, sometimes described as tormenting, and can last for weeks, especially when the person is not able to access support or inpatient treatment.

However, the Alternative to Meds Center specializes in withdrawal from Suboxone, using gentle and gradual taper methods, supported with many comfort-based therapies to make the process maximally tolerable and as comfortable and uncomplicated as possible. Endorphin repair is a great advantage for this process, and makes coming off Suboxone a sustainable and very reachable goal, especially when the strategies have been well and carefully planned, as discussed here.

Suboxone FAQs

Below are some topics of interest for anyone considering starting or stopping a prescription of Suboxone, in the hope that this information can help you or a loved one make the most well-informed decisions possible regarding safety, long-term health and sobriety.

Is Suboxone an Opioid?

Yes Suboxone is classified as a synthetic opioid drug.

How Long Does Suboxone Stay in Your System?

Suboxone is a long-acting synthetic opioid which can stay in your system for as long as two weeks after the last dose was taken. The half-life of Suboxone is approximately 37 hours, and it will take several half-lives for the drug to be cleared from the body.

Treatment for Suboxone Abuse and Addiction

There is currently an opioid crisis in the US and in other parts of the world. As part of the effort to turn back the tide on the opiate addiction problem, there have been some new strategies that have received FDA approval and broad acceptance in treatment programs, as well as changes to some commonly abused opiate drugs that are designed to deter recreational abuse.

The Alternative to Meds Center has been on the cutting edge of opiate addiction treatment for many years, utilizing a multi-pronged approach to recovery from opiate addiction.

When opiates are consumed for a period of time, the body adapts to the presence of these drugs in two major ways. One adaptation is that the body responds to opiates and opiate analogues by shutting down its normal production of endorphins, in an effort to remain balanced. Another adaptation is that the body begins building new pain receptors, to re-enable the pain-warning system built in to a healthy body.

When the opiates are withdrawn, the pain and discomfort that can occur are intense and hard to tolerate. Drugs such as Suboxone can counter-act the pain and suffering of withdrawals.

There are many ways to soften and ease opiate withdrawals, with or without the use of Suboxone or other bridge medications. The Alternative to Meds Center uses multiple techniques and therapies that are highly effective, humane, and promote healthy, sustainable abstinence.

Providing highly specific foods and supplements that supply the body with the precursors to endorphin production has been very successfully used in our opiate treatment programs. We also do lab testing to discover any accumulations of neurotoxicity in the body. Neurotoxins such as heavy metals, drug residues, chemical pollutants from household or industrial cleaners, pesticides, and many other substances can collect in the body and may result in unwanted symptoms such as insomnia, pain, depression, impaired internal organs, anxiety, behavior changes, and many other unwanted reactions.

Cleansing the body of these accumulations through a non-invasive and pleasant process can result in much relief. Our addiction treatment program includes the use of therapeutic sauna, nebulized glutathione, physical massage therapies, mineral spa treatments, clay packs, Reiki, and many other beneficial methods. In this way, we can help remove the causes of unwanted symptoms that may have begun to plague a person long before habitual or chronic drug use occurred.

There is abundant information available on the many strategies used at the Alternative to Meds Center opiate recovery program. Please reach out to us and we can freely share these and other information regarding Suboxone or other types of drug dependency.

  1. SAMHSA Outline of Medication Assisted Treatment (n.d.) accessed Oct 22, 2018 https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
  2. FDA News Release June 14, 2018, accessed Oct 22, 2018 https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm610807.htm
  3. US Dept of Health Report (n.d.) accessed Oct 22, 2018 https://www.hhs.gov/opioids/  
  4. NIH Heavy Metal Poisoning/Symptoms )n.d.) accessed Oct 22, 2018 https://rarediseases.info.nih.gov/diseases/6577/heavy-metal-poisoning

This content has been reviewed, and approved by a licensed physician.

Dr. Michael Loes, M.D.

Dr. Michael Loes is board certified in Internal Medicine , Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally he is a well published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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