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Suboxone and Opiate Drug Detox

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Updated June 25, 2014

Suboxone and Opiate Drug Detox

Suboxone 8mg tablet

Photo © Gold Standard

Classification:

Suboxone is actually a combination of two different drugs:

  • Buprenorphine - a partial opiate agonist, meaning this medication can both block and stimulate opiate receptors in the brain.

  • Naloxone - an opiate antagonist, meaning it blocks opiates from bonding to receptors in the brain that stimulate the release of dopamine (the brain chemical that causes feelings of euphoria).

Form:

  • 2mg tablets or 8mg tablets

Induction Dosing:

The goal of this step is to transition you from the opiates you currently take to Suboxone.

Your first dose will be given under the observation of your doctor. Suboxone tablets are placed under the tongue and allowed to dissolve. You should begin to feel better after about an hour. Depending on how well your first dose suppresses the symptoms of withdrawal, a second dose may be given by your doctor.

The typical daily dose of Suboxone can range from 4mg to 24mg.

Stabilization Dosing:

It's during this stage that the dose of Suboxone is adjusted to the lowest dose that suppresses withdrawal symptoms.

Your doctor will discuss the plan for your recovery and how Suboxone will fit into that plan.

You and your doctor will decide if Suboxone will be used long-term as a maintenance therapy, or whether Suboxone will be gradually tapered and discontinued.

Maintenance Dosing:

For some, Suboxone will be used at a maintenance dose during recovery. During this phase, addiction counseling is important. In fact, the success of your treatment can be greatly improved by attending some sort of professional counseling after you have stopped taking opiates.

If maintenance dosing is chosen, Suboxone will be prescribed at the lowest possible dose that is effective at stopping withdrawal symptoms or opiate cravings. For some, this phase can last months or even a year or more.

Medical Withdrawal Dosing:

For some, Suboxone treatment will not be long-term. But because the drug is a opiate agonist, the Suboxone must be tapered slowly over the course of several weeks. If the drug is stopped abruptly, withdrawal symptoms similar to those experienced at the time of induction can occur.

During this phase, your doctor will slowly decrease your dose, being careful to do so in a manner that produces the fewest withdrawal symptoms or opiate cravings.

The eventual goal of this phase is to stop Suboxone treatment altogether.

Special Instructions:

You must be experiencing withdrawal symptoms at the time of induction. If you are not, the induction of Suboxone will cause the sudden onset of withdrawal symptoms that can be very uncomfortable.

More Information:

The Complete Suboxone Guide

For more information on Suboxone try About.com's Drug Finder

Source:

Gowing L, Ali R, White J. Buprenorphine for the management of opioid withdrawal (Cochrane Review). In: The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd.

Strain E, Stitzer ML. Introduction and historical overview. In: Methadone Treatment for Opioid Dependence. Strain E, Stitzer ML, eds. Baltimore, Md: The Johns Hopkins University Press; 1999.

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