How helpful is Suboxone for bearing heroin withdrawal? As with any drug, individual response varies but overall, Suboxone is quite effective for easing both withdrawal symptoms of heroin and other opioids and also for curbing drug cravings. It’s these cravings that can persist for months after the clinical withdrawal symptoms have ceased, causing relapse and treatment failures.
The narcotic in Suboxone, buprenorphine, was first discovered in the mid-1960s. No one paid much attention to it for the next 30 years or so until the AIDS epidemic focused on the high incidence of the virus among intravenous drug users. These people often shared needles, and this allowed the virus to pass easily between users. Buprenorphine was introduced to help heroin addicts stay clean by preventing opioid withdrawal symptoms. Although methadone was already available for this purpose, it was dispensed only at licensed methadone clinics. These clinics require clients to show up daily for their dose. This can be incredibly intrusive into someone’s daily routine. It can interfere with work and family responsibilities. Not everyone lives near a methadone clinic, either.
Buprenorphine, under the trade name Subutex, changed all that because it could be prescribed as a monthly amount to be filled at any pharmacy and taken at home. However, Subutex had a problem. When crushed, dissolved in water and injected intravenously, it could produce an intense high. This liability led to the introduction of Suboxone in 2002. Its narcotic component, buprenorphine, was the same, but Suboxone included the opioid overdose rescue drug naloxone. With Suboxone, if it were injected, the naloxone would not only block any high from the buprenorphine but would cause an instant withdrawal effect. Naloxone has no effect when taken as directed by mouth.
How Effective is Suboxone?
Suboxone works for most people most of the time. It typically relieves all or most of the withdrawal symptoms. When it fails, it’s usually because the person was taking very potent opioids in high doses. In this case, the buprenorphine in Suboxone may not be sufficient to alleviate opioid withdrawal symptoms enough or even at all. In rare cases, it just doesn’t work for unknown reasons. It’s also possible, although very rare, to be allergic to any of the ingredients in Suboxone.
When Suboxone doesn’t work, methadone almost always will. It’s not as safe or as convenient as Suboxone is, but methadone will relieve withdrawal symptoms and suppress drug cravings in virtually anyone. Methadone therapy can be started at any time.
Drawbacks of Suboxone
Suboxone has one significant flaw: it cannot be started until the person is well into the withdrawal process. This means no less than 24 to 36 hours after the last dose of an opioid. This also means that the person will be in considerable pain and discomfort for many hours or even more than a day before they can obtain relief. This waiting period is a real problem, because not everyone is going to be willing to do this. They may also take their opioid of choice just to get relief.
Taking Suboxone too soon after the last dose of opioid can cause precipitated withdrawal or PW. The drug reacts with the brain’s opioid receptors in a way that causes an extreme intensification of withdrawal symptoms. This reaction has two causes:
- Buprenorphine’s higher affinity for the brain’s opioid molecules
- Buprenorphine is a partial narcotic agonist
When buprenorphine enters the brain, it attaches to the opioid receptors located there. If other opioid molecules are already present, it will displace those because it has a higher preference for the receptors that most other opioids do. The brain is used to the other opioid, though, and it doesn’t like it too much when the buprenorphine takes over the receptors. This is because it’s a partial narcotic, not a full one. Buprenorphine can’t fully activate the receptors, which is the main reason why it doesn’t cause the same high that other opioids can.
If buprenorphine takes over the brain’s opioid receptors while another opioid is present, it will result in the brain’s receptors being occupied by a partial narcotic, not a full one. The brain isn’t used to that, and that’s why precipitated withdrawal occurs. PW cannot be reversed or treated, and the person will just have to wait up to several days, in misery, until the brain adjusts and the Suboxone can work like it should.
Never take Suboxone too soon into the opioid withdrawal timeline. A medical professional will evaluate your progress and decide when it’s safe to start Suboxone.
For More Information
Call us anytime at 844-903-2111 for information about Suboxone or if you have any questions. We’re here to help 24 hours a day.