An article in the Aids at About.com archives tells of LK, a man who after many years of Vicodin use became physically and emotionally dependent on the drug. His use became out of hand, as he took several times the prescribed dose each day. He knew he had to do something. He decided to stop his Vicodin use by slowly cutting back the amount he took each day. He had no idea of the difficult road that lay ahead. After a couple weeks, he had cut back his use a bit but felt miserable due to withdrawal symptoms. His attempt to quit failed when he resumed his excessive use not soon after.
Opiates are the most abused of all drugs. While many wish to quit, the physical and emotional attraction to opiates makes it almost impossible for most. But now there is hope for those people with opiate addiction who want to quit. The drug Suboxone is offering people with opiate addiction new hope in their attempts at kicking the habit. Let's take a look at addiction and dependence and how Suboxone can help kick the habit.
What Are Opiates?Opiates are a family of drugs derived either naturally or synthetically from the seed of a plant known as the poppy. Opiate drugs are narcotic sedatives that depress the activity of the central nervous system, reducing pain and inducing sleep. While opiates are an effective treatment for many types of moderate to severe pain, they have a high incidence of physical and emotional dependence. Long-term use of opiates can result in tolerance of the drug, meaning the amount taken must increase to acheive the same effect. As the amount of opiates increase to compensate for tolerance, dependence can occur. Often, dependence can lead to opiate overdose and even death. Some of the most commonly prescribed opiates include:
- Vicodin (hydrocodone)
In addition to the prescribed opiates mentioned, the illegal drug, Heroin is also an opiate.
Understanding Opiates and The BrainThe human brain is an amazing thing. One of the most ingenious characteristics of the brain is its reward system. The brain is wired to promote survival. In fact, the brain will reward the body for things it recognizes as being necessary for survival. The chemical dopamine causes these feelings of euphoria as a positive reinforcement for the behavior. Think of it as you giving your dog a treat when he sits on command. Your brain treats your body when you engage in a behavior the brain recognizes as important.
The Possible Role of Memory and TriggersStudies have shown that addictive drugs such as opiates stimulate dopamine release and in turn our brain's reward system. In addition to inducing euphoria, dopamine stimulates the memory centers of the brain. Research from the Harvard Medical School suggests that because opiates stimulate the release of dopamine and dopamine stimulates the memory centers, there may be a memory component to addiction. It is suggested that dopamine release at the hand of opiates can create long-lasting memories linking opiates to a pleasurable reward. The concept of "addiction triggers" is considered by some to be an example of how memory may play a role in addiction
Certain circumstances surrounding opiate use are memorized as triggers. For instance, driving by the pharmacy where you purchase your pain pills may cause a sudden craving for your opiates. Triggers are those memories that remind us of the good feelings produced by opiates. They leave us with the desire to recreate the event that was rewarded with pleasurable sensations. In the case of opiate addiction, it is the pleasurable feelings you get after taking your dose of opiates. In many people, these triggers drive their continued opiate use and addiction.
How Does Suboxone Help?Suboxone (buprenorphine + naloxone) has been approved for the treatment of opiate dependence. It is actually two drugs in one pill.
- Buprenorphine - This is the active ingredient in Suboxone. Buprenophine is a partial opioid agonist, meaning it can both activate and block opiate receptors, depending on the clinical situation.
- Naloxone - This drug is an opiate antagonist, meaning it blocks the effects of opiates. When Suboxone is taken under the tongue as prescribed, naloxone is not absorbed in sufficient amounts to have a clinical effect. Because Suboxone is an opiate agonist (a molecule that can trigger a receptor), there is a risk of misuse by people addicted to opiates. To prevent this, naloxone was combined with buprenorphine. If Suboxone is crushed and injected in hopes of getting an opiate "high," naloxone blocks the effect of opiates, producing severe withdrawal symptoms.
If Suboxone is chewed or crush and injected, the naloxone contained in the drug will produce severe opiate withdrawal symptoms.
How Does Suboxone Help Beat Opiate Addiction
- When opiates are taken into the body, they attach to receptors in the brain, causing dopamine release and euphoria.
- Eventually, opiates leave the receptors causing the feelings of euphoria to fade and the symptoms of withdrawal to begin.
- As more of the receptors become empty, the withdrawal symptoms worsen. At this point, Suboxone therapy can begin.
- When Suboxone is taken, the buprenorphine attaches to the receptors in the brain once occupied by opiates. Because the receptors are no longer empty, withdrawal symptoms diminish.
- Buprenorphine attaches firmly to the receptors, filling them and blocking other opioids from occupying those receptors. Buprenorphine has a much longer duration of action than do other opioids, so the effects do not wear off quickly as is the case with opiates.
- Because there are no withdrawals, the person can stop taking opiates and start working on kicking his opiate habit.
Suboxone does work but it's not as simple as just taking a pill. Page two guides us through the Suboxone treatment schedule.