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What is Suboxone? How does it work?

Updated: Dec 26, 2022

By Giovanni Pierre, PMHNP-BC

Suboxone, a form of the drug buprenorphine, is one of the most common treatments used to help individuals struggling with opioid use disorder overcome their addiction. While it can be effective, it’s not without its fair share of myths and misconceptions surrounding it. To help dispel some of the myths that surround this drug and its uses, we’ll be taking a look at the most popular ones today.

How does Suboxone work? Some people mistakenly believe that suboxone is a medication to help users get off of heroin. The reality is, it’s much more complicated than that. When someone abuses opioids (heroin, oxycodone, etc.), it becomes very difficult for their brain to create dopamine, our feel-good neurotransmitter. This causes an intense desire to use again and again because they don’t feel normal. With suboxone, it is able to trick your brain into thinking it has enough dopamine by binding with opioid receptors in your brain. This allows you to still feel pleasure from things like food and sex without feeling high or experiencing withdrawal symptoms when you stop taking suboxone.

What are its side effects? The main side effect of suboxone is a rare but potentially life-threatening reaction called anaphylaxis, which can cause shock and other symptoms. The drug may also trigger withdrawal symptoms in patients who take it while they are still using heroin or other opioids, a condition known as precipitated withdrawal. If you’re concerned about side effects, talk to your provider. He or she will help you weigh any potential risks against the benefits of taking suboxone to manage your addiction.

Is it addictive? Contrary to popular belief, suboxone is not addictive. However, it’s understandable why there would be confusion about that claim. After all, suboxone contains an opioid—buprenorphine—which means it can cause physical dependence in some people. But because buprenorphine is a partial agonist at mu-opioid receptors (meaning its effects are weaker than full agonists like heroin), physical dependence and addiction are less likely than with other opioids.

Are there risks? Yes, there are side effects and risks associated with suboxone that should be taken into consideration. The drug blocks opiate receptors in your brain, but it also blocks receptors in your central nervous system, gastrointestinal tract, and kidney, which can lead to problems including increased pain perception, nausea, and constipation. Some research also suggests that addiction can persist even when you’re on medication-assisted treatment (MAT), though the evidence is mixed on whether suboxone has a higher rate of relapse than other MAT medications.

Who should use Suboxone? Suboxone is a medication used to treat opioid use disorder (OUD) or opioid addiction. OUD is an uncontrollable need to use opioids; these may include prescription painkillers, heroin, and fentanyl. Suboxone helps in a number of ways: It acts as a partial agonist, attaching to opioid receptors in your brain but not creating a high or relieving withdrawal symptoms like agitation and nausea. The drug also contains naloxone, which counters any overdose effects from other opioids. This medication can be taken under supervision at home or can be prescribed by providers to be administered in a clinic setting. In order to take suboxone, you must have been addicted to opioids for at least one month and have undergone detoxification treatment.

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