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Patient Information on Buprenorphine (Suboxone, Subutex)

Although psychological treatment is the foundation of the Kolmac Clinic rehabilitation program, medication can play an important supportive role. Buprenorphine, also known as suboxone treatment, is one of those medications that has significantly improved our ability to help patients seeking outpatient drug treatment to recover from addiction to pain medications and heroin. It greatly reduces or entirely eliminates withdrawal symptoms. It also eliminates drug craving and leaves people feeling comfortable enough to return to a normal life without being distracted by drug cravings. The following information is intended to help patients understand the role that this medication can play in their recovery.

                         

What is buprenorphine and how does it work?

It is an "opioid" medication that has been used in Europe since the 1980's for the treatment of addiction and was approved for that use in this country in 2003. It attaches to the same places in the brain that heroin and pain medications do. Because it only partially activates these sites, it does not make people high, although some people do report feeling a "buzz." It also prevents people from getting high on other opioids by blocking the effect of these substances. Suboxone treatment is used by drug detox programs around the world.

Can buprenorphine cause physical dependence?

Yes. If you suddenly stop taking it, you will probably experience withdrawal symptoms. Because it is long acting, this may take 2 days to begin. Therefore when you decide to get off of buprenorphine, you should reduce the dose gradually over a period of time and not discontinue it abruptly.

What are Suboxone and Subutex?

Suboxone and Subutex are the "brand" names for buprenorphine (which is the "generic" name). Suboxone has the opioid blocker, naloxone, compounded with the buprenorphine. When using a suboxone treatment, the naloxone is not absorbed when the pill is dissolved under your tongue. It is only there to discourage people from dissolving the pill and injecting it, in which case the naloxone works as a blocking agent. Subutex is a preparation containing only buprenorphine and no naloxone. Over time, buprenorphine has been shown to be very effective in outpatient drug treatment.

How is buprenorphine taken?

To be most effective, it should be allowed to dissolve under the tongue.  Try not to swallow until after it is dissolved.

How is buprenorphine different from methadone?

  • It is safer. Overdose is almost impossible.

  • Sedation is less.

  • It blocks the effect of pain pills and heroin at lower doses than methadone does.

  • You can get prescriptions for it by “waivered” physicians in a traditional office setting.

What are possible side effects and what can I do about them?

  • Nausea: Spit out your saliva rather than swallowing it after buprenorphine has dissolved.

  • Sleepiness: Take medication at bedtime.  Consult with doctor about reducing dose.

  • Constipation: Increase fiber in diet.  Consult with doctor about reducing the dose.

How long should I stay on buprenorphine?

You can decide to get off buprenorphine at any time. We recommend that you remain on suboxone treatment for one year of stabilization because the danger of relapse in early recovery for most drug detox programs is very high. Some patients have decided to stay on it for years.

 

At the Kolmac Clinic, induction into buprenorphine treatment can be done at our Silver Spring and Towson offices; however, buprenorphine treatment can be continued at any of our six outpatient drug treatment locations, including Washington, DC and Baltimore, Columbia, and Gaithersburg, MD.

 

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