The idea that taking Suboxone means switching out one addiction for any is false, however, that doesn’t mean Suboxone is a completely risk-free medication. Like many other prescription drugs, Suboxone can be addictive if it is misused, but it is generally safe when taken as directed.
This article will discuss the topics of Suboxone abuse and addiction. You will learn:
- What Suboxone is
- How it treats opioid use disorder
- The abuse potential of Suboxone
- Signs of Suboxone addiction
If you or a loved one think you are addicted to Suboxone, don’t hesitate to reach out for help. Call First Step Behavioral Health today to speak with an addictions specialist.
What is Suboxone?
Suboxone is a prescription medication used to treat opioid dependence. It was approved by the U.S. Food and Drug Administration (FDA) in October 2002. It is intended to be used in combination with counseling and behavioral therapy in an approach known as medication-assisted treatment or MAT.[1,2]
Suboxone comes in the form of a sublingual film or tablet that contains two active ingredients: buprenorphine and naloxone.
- Buprenorphine – is a partial opioid agonist, meaning it activates opioid receptors in the brain but to a lesser extent than full agonists like heroin or oxycodone. This helps to reduce cravings and withdrawal symptoms without producing the same euphoric effects.[3]
- Naloxone – an opioid antagonist that is added to Suboxone to reduce the abuse potential. It works by blocking the euphoric effects of opioids. When taken sublingually as directed, the naloxone has minimal effect, but if Suboxone is injected, the naloxone will cause sudden withdrawal symptoms.[4]
Suboxone is prescribed to individuals who are seeking treatment for opioid addiction. People must abstain from opioids for 12-24 hours before starting Suboxone. Once taken, it helps reduce the severity of opioid withdrawal and cravings, making it easier to abstain from opioid drugs.
Is Suboxone an Opioid?
Yes, Suboxone is technically considered an opioid. However, there are two types of opioids:
- Partial agonists – Partial opioid agonists, such as buprenorphine, activate opioid receptors but produce less intense effects compared to full agonists.
- Full agonists – Full opioid agonists, such as heroin or oxycodone, fully activate opioid receptors, resulting in stronger euphoric effects and a higher risk of dependence and overdose.[5]
Suboxone’s combination of buprenorphine and naloxone helps mitigate withdrawal symptoms and cravings associated with opioid dependence while reducing the risk of misuse and overdose.
Is Suboxone Addictive?
The U.S. Drug Enforcement Administration (DEA) has classified buprenorphine as a Schedule III controlled substance, indicating a low to moderate risk of physical or psychological dependence. Most prescription opioids, like oxycodone, methadone, and fentanyl, are Schedule II controlled substances, indicating a higher potential for abuse and addiction than buprenorphine.[6]
If abused, Suboxone can be addictive. However, it’s unlikely to develop an addiction to Suboxone because the medication has a “ceiling effect.” The ceiling effect means that once a certain dose is reached, the effects stop getting stronger. Suboxone’s ceiling effect occurs at 24 mg/day. Taking more than this won’t result in any added euphoric effects.[2,3]
Sometimes, the terms “addiction” and “dependence” are used interchangeably, but they mean two different things. Addiction is characterized by compulsive and dangerous substance abuse as well as loss of control. Dependence, on the other hand, occurs when the body adapts to a substance and experiences withdrawal symptoms when the substance is stopped.[7] Dependence can occur with many types of medications, including opioids, benzodiazepines, stimulants, and even antidepressants.
Not everyone who is physically dependent on a substance is addicted. However, most people who are addicted to a substance have some level of physical dependence on it.
Signs of Suboxone Addiction
People who abuse Suboxone by taking higher doses than prescribed or by using it to stave off withdrawal symptoms in between doses of opioids are at an increased risk of adverse side effects and addiction. Taking too much Suboxone at once can result in:[3]
- Poor coordination
- Slurred speech
- Drowsiness
- Difficulty concentrating
- Shallow breathing
- Blurry vision
- Nausea
- Itching
- Reduced appetite
- Respiratory depression
- Overdose
People who become addicted to Suboxone may exhibit common signs of addiction, including:
- Experiencing withdrawal symptoms when not taking it
- Intense drug cravings
- Loss of control over drug use
- Multiple failed attempts to stay sober
- Engaging in risky behaviors
- Physical or mental health problems as a result of drug use
- Continuing to use drugs despite the consequences
- Loss of interest in hobbies and activities that used to be enjoyed
- Neglecting responsibilities
- Manipulating or lying to others
- Spending too much money on drug abuse
- Visiting multiple doctors in an attempt to get multiple Suboxone prescriptions
- Purchasing Suboxone illegally on the street
Symptoms of Suboxone Withdrawal
Using Suboxone long-term–whether misusing it or taking it as prescribed–can result in the development of physical dependence and withdrawal symptoms. People who misuse Suboxone may experience more intense withdrawal symptoms than those who take it as directed.
Suboxone works similarly to other opioids, so withdrawal looks like withdrawal from any other opioid drug. Common symptoms are:[8]
- Opioid cravings
- Runny nose
- Watery eyes
- Muscle pain
- Nausea
- Vomiting
- Diarrhea
- Chills
- Sweating
- Feeling hot one minute and cold the next
- Depression
- Insomnia
- Mood swings
People who have developed a dependence on Suboxone should never stop taking it cold turkey. Working with a medical provider and gradually reducing the dose over a period of time can help individuals avoid withdrawal symptoms.
If Suboxone is Addictive, Why is it Used to Treat Addiction?
Addiction is an incredibly complex disease, and everyone who suffers from it is unique. For many people struggling with opioid addiction, the most effective route to recovery is through medication-assisted treatment (MAT) with Suboxone. Suboxone can reduce cravings, alleviate withdrawal symptoms, and improve retention in treatment.
When Suboxone is prescribed, it is because the intended benefits outweigh the potential risks. If someone whose life was previously crippled by opioid addiction can take Suboxone every day, go to work, take care of their families, or tend to their daily responsibilities without abusing drugs or alcohol, the medication has done its job. People who take it as prescribed may develop a physical dependence, but they are not psychologically addicted to Suboxone in the same way they were to opioid drugs.
Suboxone is not the only medication with a potential for addiction that is regularly prescribed to treat substance use disorders. Methadone, another medication used to treat opioid use disorder, is considered more addictive than Suboxone. However, when used appropriately under the guidance of a licensed physician, these medications can be safe and effective.[9]
Find Treatment for Suboxone Addiction
Suboxone can be an effective way to treat opioid addiction, but it isn’t right for everyone. At First Step Behavioral Health, we embrace a personalized, holistic approach to recovery that targets your unique needs and addresses the mind, body, and spirit. We’ve seen firsthand how the opioid epidemic has ravaged families and communities across the United States, and we’re dedicated to helping you break the cycle.
Whether you’re addicted to Suboxone or another opioid, our team is here to help. To learn more about our treatment programs or get started with a confidential, risk-free assessment, please contact us today.
References:
- U.S. Food & Drug Administration (FDA): Drug Approval Package
- National Institute of Health (NIH): History of the discovery, development, and FDA-approval of buprenorphine medications for the treatment of opioid use disorder
- Substance Abuse and Mental Health Services Administration (SAMHSA): Buprenorphine
- Journal of Pharmacoepidemiology: Evaluation of the Effectiveness of Buprenorphine-Naloxone on Opioid Overdose and Death among Insured Patients with Opioid Use Disorder in the United States
- Indian Health Service: Pharmacological Treatment
- U.S. Drug Enforcement Administration (DEA): Drug Scheduling
- National Institute of Health (NIH): Drug dependence is not addiction—and it matters
- National Institute of Health (NIH): Buprenorphine
- National Institute on Drug Abuse (NIDA): How effective are medications to treat opioid use disorder?
