is Suboxone an opioid? Yes, absolutely. An opioid is a synthetic or semi-synthetic drug capable of activating the same opioid receptors in the brain, which are the mu, the delta and the kappa, as natural compounds found in the opium poppy do.
In comparison, an opiate is a substance found naturally in the opium poppy. Besides opium itself, which is the dark resin scraped from the outside of a scored poppy plant pod, there is morphine and codeine. These are the primary medicinal opiates. Although the terms opiate and opioid are often used interchangeably, they’re really not the same. The opioid component of Suboxone, buprenorphine, is a partial-agonist opioid. This means it can only partially activate the mu brain receptor when compared to a full-agonist narcotic, such as oxycodone, methadone, hydrocodone, hydromorphone, meperidine, oxymorphone or fentanyl.
This partial activation limits the euphoria buprenorphine can induce, if any, considerably. It also means the drug is relatively safer in terms of overdose. Buprenorphine is extremely long-acting and can continue to interact with the brain’s opioid receptors for as long as several days. This also provides a blockade. As long as the buprenorphine is active, other opioids will have little effect.
Methadone does the same thing. However, methadone cannot be prescribed for the purpose of opioid abuse treatment except by a specially licensed physician working in a methadone clinic. Methadone does have important medical uses, though, and it’s a truly superior analgesic, capable of relieving pain when no other opioid is working very well. Any physician can prescribe the drug in 5 and 10 milligram tablet form for pain, but not for any kind of opioid addiction. This is true in all 50 states, and any doctor who knowingly provides opioids to an addicted individual is breaking the law. Consequences can be severe.
Although the same rule applies to buprenorphine, the drug can be prescribed by specially licensed physicians for use in the privacy of the patient’s home. This is much less intrusive to the recovering addict’s life because they typically get a month’s supply at a time. Methadone must be dosed in a clinic under direct observation by clinic staff on a daily basis. Both methadone and buprenorphine can be hard to access because methadone clinics and buprenorphine doctors may not always be nearby.
Worse, federal law limits the number of Suboxone patients a doctor can have at any given time, further limiting access to this often life-changing medication. It makes no sense. The drug helps so many recovering addicts to reclaim their lives and their dignity, allowing them to contribute to society, be productive and to care for their families. Why limit access to it so severely? It’s stupid.
The Action of Naloxone
Suboxone also contains another drug called naloxone. More commonly known by its original brand name, Narcan, naloxone works to reverse opioid overdose by removing opioids from the brain’s receptors, especially the mu. The mu receptor is most strongly associated with both euphoria and respiratory depression. Opioids kill by suppressing the brain’s breathing center in the brain stem until the breathing reflex stops altogether. Naloxone and its chemical cousin, naltrexone, both work to restore normal breathing and protect the mu receptors from being overwhelmed by dangerous opioid levels.
Naloxone is included in Suboxone to discourage abuse of the buprenorphine. Although not very euphoric when taken orally, buprenorphine acts differently when injected intravenously. Some people can become quite high by misusing the drug in this way. However, the naloxone in the combination medication prevents this. If the Suboxone film is dissolved in water and injected, the naloxone will stop the buprenorphine from having any effect.
Buprenorphine is addictive. Although considered to be less addictive than full agonists like oxycodone, it’s still an issue. The withdrawal syndrome produced by long-term use of the drug is often severe. Many say it’s very difficult to get off of, and even the slowest of tapers still doesn’t avoid significant withdrawal symptoms. Other users report long and unsuccessful struggles with buprenorphine when they would like to discontinue it.
This is something to consider and discuss with a substance abuse professional ahead of time. Suboxone can also be used in the short term, just long enough to withdraw from other more dangerous opioids like heroin and fentanyl. The Suboxone can then be immediately tapered down and discontinued. This avoids any physical dependence on buprenorphine and may be an option in some cases but not necessarily in others.
For More Information
Just call us anytime at 772-266-5320. Our friendly, professional drug counselors are here 24 hours a day to help you with any questions you may have about Suboxone or any other substance abuse issues. We’re here to provide hope and help, and we look forward to your call.