Suboxone
Treatment with Suboxone
What is Suboxone?
Suboxone is the brand name for a medication approved for the treatment of opioid use disorder combining buprenorphine and naloxone. In other words, it is approved for the treatment of patients who suffer from addiction to opioids (such as heroin, oxycodone, fentanyl, morphine). Buprenorphine is the active ingredient of the medication. It works principally as a partial agonist to the mu-opioid receptors of the brain, i.e. it partially (and not fully) stimulates these receptors thus alleviating opioid withdrawal symptoms and cravings for opioids.
How is the medication administered?
Suboxone is supposed to be administered sublingually, i.e. the medication is placed under the tongue where it dissolves in the saliva and gets absorbed.
Why is naloxone included in the formulation?
Naloxone is an antagonist to the same receptors, i.e. it blocks opioids from having an effect on these receptors. The only reason naloxone is present in this medication is to prevent abuse. Naloxone is not absorbed in the body when the medication is being administered sublingually. In other words, it has no effects to the body under normal circumstances. However, if the medication gets administered intravenously by a person abusing the medication, naloxone will enter the body, block the majority of the effects of buprenorphine (or other opioids) and will likely precipitate severe opioid withdrawal to a person taking opioids daily. Basically, including naloxone in this formulation increases the safety of the provided treatment in the event of abuse.
Is Suboxone addictive? Why prescribe a medication with addictive properties?
Suboxone has minimal to mild euphoric/intoxicating effects to tolerant patients who use opioids daily. It mainly prevents withdrawal and decreases the cravings for opioids. It is not nearly as addictive as frequently abused opioids. It has been shown in rigorous scientific studies to help prevent relapse to opioids and to decrease the harm caused by ongoing use to the patients and their community.
Is it OK to use other substances while taking Suboxone?
No, abstinence from any and all substances is the goal and is required in order to continue the treatment with Suboxone. Regular urine drug screen testing is required to monitor response to treatment and ensure its safety.
Is Suboxone administered by itself or additional treatments are provided concurrently?
Psychotherapy is a treatment provided simultaneously with Suboxone to support and assist the patients in their recovery from opioids. It has been shown to improve the outcomes of treatment with suboxone. Active participation in psychotherapy is required based on most treatment protocols. In addition, any underlying psychiatric disorders (e.g. depression, anxiety) are also being addressed as indicated.
What type of treatment does Dr. Panagopoulos offer for opioid use disorder (opioid addiction)?
Dr. Panagopoulos does not currently offer treatment with Suboxone due to restrictions related to practicing exclusively over telemedicine.
Here is a good resource for finding providers who provide treatment with Suboxone in your area:
https://www.samhsa.gov/medication-assisted-treatment/find-treatment/treatment-practitioner-locator
Dr. Panagopoulos, a double-board certified addiction psychiatrist with significant related experience in the treatment of opioid use disorder, does offer other treatments for opioid use disorder including naltrexone to the residents of New York, Texas and California. This includes both medication management services regarding the prescribing of naltrexone as well as psychotherapy services in a compassionate and individualized manner adhering to the most up-to-date treatment guidelines.
Thank you for your interest in mental health and in our services! Feel free to schedule your online consultation with Dr. Panagopoulos.
