Suboxone is a combination drug product containing the synthetic opioid buprenorphine and the semi-synthetic opioid overdose antidote naloxone. You may be more familiar with its brand name Narcan. Buprenorphine was first developed in 1965 and then approved for use in the United States in 1981. Suboxone has only been in common use as an opioid withdrawal and maintenance medication for about the past 20 years. Because it’s synthetic and not derived from opium as other opioids like morphine, oxycodone and hydrocodone are, buprenorphine may have some long-term effects not associated with other opioids derived from a natural source. This phenomenon has been seen in the past with meperidine, a synthetic opioid once popular in emergency and obstetrical medicine. It’s now known that meperidine can cause problems with muscle tremors and seizures if taken in a high dose or in the long-term. This article will answer the question: What are the long term effects of taking Suboxone?
Suboxone works by binding to the same brain receptors that all opioids do. The brain has three main receptors for opioids. These are the mu, the delta and the kappa. The mu is most associated with both opioid effects and withdrawal. It’s also the mu most responsible for the fatal effects of opioid overdose. This occurs when more opioid has been ingested than the brain can handle. The excess opioid then binds to mu receptors located in the brain stem, overwhelming the delicate balance. The brain stem is responsible for basic life functions like breathing and heart rate. If too much opioid is taken, the brain stem loses its ability to detect blood carbon dioxide levels and fails to send the signal to breathe.
Suboxone is only a partial agonist. This means it only partially activates the mu receptor, but this is enough to stop withdrawal symptoms and ease drug cravings. This partial agonist activity limits Suboxone’s ability to cause euphoria. It also makes the drug safer with regard to overdose. Most recovering opioid addicts using Suboxone just feel normal while taking it. There is rarely any kind of high. The only way to possibly get a high from buprenorphine for anyone with an opioid tolerance would be to dissolve the film in water and inject it into a vein. That’s why the naloxone is there. If anyone tries to take Suboxone by injection, they will be very sorry. The naloxone will cause an instant, untreatable, full-blown withdrawal reaction. Most opioid addicts are aware of this and wouldn’t even try it.
Long-Term Effects of Opioids
Not too long ago, it was thought that opioids caused no organic damage to the body. Other than addiction, dependence, possible overdose and constipation, opioids weren’t known to damage the body when taken in the long-term. We know today that this is not true. These are some of the problems associated with long-term opioid use:
- Loss of libido
- Sexual dysfunction
- Edema of the legs and feet
- Muscle weakness
- Osteoporosis
- Infertility
- Weakened immune system
- Hyperalgesia
Hyperalgesia is a curious condition in which the person taking an opioid for a long time experiences a heightened response to pain. Extended use of opioids also causes changes in the brain, including the growth of extra opioid receptors and the cessation of production of certain natural painkillers called endorphins. The opioid receptors may also down-regulate, increasing pain levels while simultaneously decreasing the analgesic effects of the ingested opioid. It is not known at this time if Suboxone has other long-term effects of its own, but since it’s an opioid, it likely will share at least some of the above negative effects.
A Matter of Balance
Like any drug, opioid or not, there is a relationship between risk and benefit. Are the potential risks worth the benefit? This is a question that you must decide with your doctor. It’s also a matter of relative risk: Taking Suboxone is certainly better and safer than buying so-called heroin on the street and risking death with every use. There is no way to know for sure what the strength of that heroin is or what it has been cut with. Fentanyl and its even more powerful analogs are commonly used to cut street heroin. Even oral opioids can kill if enough is taken, and people buying prescription opioids on the black market also risk death with every dose because these pills are often counterfeit.
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