WHAT IS MEDICATION ASSISTED TREATMENT –OFFICED BASED PROGRAM

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Suboxone is a combination of two medications buprenorphine and naloxone. These medications are used in Medication Assisted Treatment to help suppress cravings, reduce withdrawal symptoms, reduce long term dependence, and aid in reducing overdose.

The Buprenorphine in Suboxone is called a partial agonist. This means that it binds to the same receptors in your brain as opioids but without causing as intense feeling of euphoria or a high as the opioid.  When it binds to these receptors it prevents the opioid you are using from binding to these receptors and stops them from their ability to stimulate a “high. Some drugs example benzodiazepines and many others when combined with Suboxone can result in overdose and death. Suboxone (Buprenorphine/Naloxone) should never be combined with other drugs unless these are verified and cleared by your health care provide.

• Heroin 

• Fentanyl 

• Codeine 

• Morphine 

• Hydrocodone 

• Oxycodone 

• Methadone

• Cocaine 

• Crystal Meth 

• Benzodiazepines such as Xanax (alprazolam), Klonopin(clonazepam), Valium (diazepam), Ativan (lorazepam) and Restoril (temazepam)

Due to the quick elimination of opioids in the brain by Buprenorphine, taking opioids too close to the time of Suboxone can lead to a sudden onset of intense withdrawals. As a result, evidence states that you should start taking Suboxone around 12 to 24 hours after using opioids.

There is no set duration of treatment with Suboxone (Buprenorphine/Naloxone). Duration depends on individual factors, and this is why it is important to have a team of providers who understand your individual needs. The length of time you stay on Suboxone (Buprenorphine/Naloxone) depends on your strengths and challenges. Some people may stay on Suboxone (Buprenorphine/Naloxone) for a few months, while others may be on it for the rest of their lives. 

• Nausea 

• Vomiting 

• Insomnia 

• Weight loss or sudden weight gain

• Stomach cramps 

• Dizziness or feeling lightheaded

• Sweating 

• Dry Mouth 

• Mood Changes

How do I know if Suboxone (Buprenorphine/Naloxone) is right for me?

If you are struggling with opioid dependence, Suboxone (Buprenorphine/Naloxone) can be an effective option and tool to aid in your recovery. Our team will provide you with a comprehensive evaluation to determine if you qualify. Qualification is dependent on several factors including the phase of withdrawals you are in, what drugs you are currently taking, and several psychosocial factors. If maintaining withdrawals at home and in an office-based setting is safe for you, our team will develop a Medicated Assisted Treatment plan that is individualized to your needs.

Can I become addicted to Suboxone (Buprenorphine/Naloxone)?

Yes. Like many medications, if used incorrectly and for recreational purposes it can become addictive.

However, if you follow the treatment plan laid out by your provider, Suboxone Buprenorphine/Naloxone) can be used safely without the fear of addiction. 

Will Suboxone (Buprenorphine) show up on a drug screening?

Buprenorphine, which is a component of Suboxone (Buprenorphine/Naloxone), does show up on drug screens if the screen specifically tests for it. Suboxone (Buprenorphine/Naloxone) is an approved treatment for addiction by the Food and Drug Administration and is a legal medication. You do not need to be concerned about legal problems or employment complications as long as you have a prescription for use.

Does Suboxone (Buprenorphine/Naloxone) interact with other drugs or medications?

It is important to disclose all medications and substances that you are taking with your provider because Suboxone (Buprenorphine/Naloxone) can have a strong interaction with certain substances. 

What if I no longer wish to take Suboxone (Buprenorphine/Naloxone)? Can I stop or switch to a different medication?

Suboxone (Buprenorphine/Naloxone) is a flexible option for those who wish to end their dependence on opioids. Suboxone (Buprenorphine/Naloxone) can be safely tapered and is approved for both short-term and long-term use. We are dedicated to preserving the autonomy of our patients and every decision is geared toward your individual needs. 

What is Suboxone (Buprenorphine/Naloxone) treatment like at Live Well Integrative Medicine?

At Live Well Integrative Medicine, our medical team evaluates each patient to determine if Suboxone (Buprenorphine/Naloxone) would be a beneficial addition to his or her comprehensive treatment plan. If so, patients receive a weekly prescription to start their wellness journey. You will come in for daily, weekly, Bi-weekly and monthly visits depending on your treatment plan. We also offer other medications that are similar to Suboxone (Buprenorphine/Naloxone), such as Subutex, which is safe for pregnant women.

The following are among the causes and risk factors that can make individuals more likely to develop opioid use disorder:

Genetic:  Individuals who have a family history of opioid abuse are at an increased risk of developing substance use disorder. In addition to a having a family history, there are certain personality, cognitive, and behavioral traits that can predispose an individual to substance use disorder. 

Environmental: There are several environmental factors that increase the risk for opioid use. These including, difficult home life and poor levels of parental supervision, family conflicts, experiencing a traumatic event, easy access to opioids, previous prescriptions for opioid use, peer groups and friends who are using opioids and have a strong influence on your behavior. 

The signs and symptoms are dependent on the type of opioid that is being abused. The following are some of the signs and symptoms an individual may exhibit but this is not an all-inclusive list. 

Behavioral symptoms:

• Visiting multiple doctors in order to receive multiple painkiller prescriptions• Slurred speech• Demonstrating a decline in performance at work or school• No longer fulfilling obligations at home• Using opioids in situations that are hazardous, such as driving while impaired• Withdrawing from family and friends• No longer partaking in activities that were once enjoyed or deemed important• Compulsive, prolonger use of opioids• Engaging in drug-related crimes

Physical symptoms:

• Psychomotor agitation• Psychomotor retardation• Pupillary constriction• Drowsiness• Insomnia

Cognitive symptoms:

• Memory impairment• Impaired judgment• Suicidal ideation• Cravings for continued opioid use• Attention and concentration difficulties

Psychosocial symptoms:

• No longer finding interest in things that one was once interested in• Euphoria followed by apathy• Depression

• Increase risk for suicidal ideation and or suicide attempts
• Engaging in criminal behavior and activities 
• Financial instability that can lead to homelessness 
• Poor performance or a decline in performance at work and school 
• Increased risk for contracting infections such as HIV/AIDs, Hep B, Hep C, bacterial infections, and endocarditis that can result in the need for heart valve replacement
• Anoxia which is a deficiency in the amount of oxygen that reaches the tissues 
• Dry mouth and nose
• Constipation as the result of decreased gastrointestinal activity 
•  Impairment of certain sensory and motor skills 
•  Track marks or sclerosed veins
•  Relationship disturbances
  

Cessation of opioid use suddenly without guidance from a healthcare provider or without the proper tools can be dangerous. When individuals have participated in a long-term pattern of opioid abuse but then stop their abuse suddenly, they will likely go through withdrawal. Withdrawal is the result of the body not getting the chemical it had become accustomed to. The following are some of the things that you may experience during withdrawals. 

• Excessive Yawning 
• Muscle aches 
• Agitation, anxiety, panic
• Increased tearing, runny nose, and excessive sweating 
• Nausea, vomiting, diarrhea, and abdominal cramping 
• Inability falling asleep or staying asleep 
• Dilated pupils, rapid heart rate, and high blood pressure 

Effects of Opioid Disorder 

Long-Term use of opioids results in developing a tolerance. Those that then use opioids long term may find themselves requiring larger and larger amounts of the opioid which increases the risk of overdose. As the need for larger amounts increase, the individual may take the opioid in amounts that the body is not able to process resulting in overdose.  The following signs may indicate that an individual has experienced an opioid overdose:

• Pin-point pupils with cold and clammy skin 
• Shallow, slow, or labored breathing 
• Confusion, severe sleepiness, and significantly slurred speech 
• Seizures 
• Dizziness and headache 
• Loss of consciousness