Suboxone and Buprenorphine Detox

Some detox centers do not medicate their patients during withdrawal. This is known as “cold turkey” and Sunrise Detox doesn't believe in it. Opiate withdrawal symptoms can produce potentially dangerous health situations, including high blood pressure and dehydration. Left untreated, the pain of the withdrawal symptoms can make it psychologically difficult to stay in the detoxification facility, and makes the client more likely to leave prematurely.

Subutex (buprenorphine)

At Sunrise Detox we use Suboxone®, buprenorphine-based medication that effectively manages opiate withdrawal symptoms. This medication allows our clients to remain comfortable and alert during their stay with us. We supplement the buprenorphine with a number of other medications to treat any discomfort that may arise. Buprenorphine also allows the client to leave detox with virtually no withdrawal symptoms. This treatment works with all opiates.

Buprenorphine is an opioid (opium-like) drug that is not as “powerful” as other opioids such as Oxycontin, Vicodin and heroin. Used correctly, alone or with naloxone, it is an effective aid in medically-monitored withdrawal from opiates.

Suboxone is a combination of buprenorphine and naloxone. The combination of the two drugs reduces their potential for abuse. Suboxone was approved for treatment of opioid addiction in 2002. It is administered sublingually (allowed to melt beneath the tongue).

Although it is possible to get “high” on buprenorphine, the euphoria is not as intense as with other opioid drugs, and is less likely to cause respiratory depression. With increasing doses, a level is reached where the user ceases to become more intoxicated (ceiling effect). In high doses, buprenorphine can block the action of other opioid drugs and cause withdrawal. At lower doses, it allows addicts to withdraw from other opioid drugs without experiencing the typical severe symptoms of withdrawal that are the first obstacle to getting off of opiate-type drugs.

Because of its ceiling effect, reduced respiratory depression, and the fact that the body does not absorb it as efficiently, buprenorphine is safer in cases of overdose than other opioids. Side effects are similar to those of other opioid drugs, including nausea and constipation, but they are far less severe.

Suboxone (buprenorphin & naloxone)

Buprenorphine and Suboxone can be abused, especially by people who are not addicted to opiates. Addicted people usually find that doses low enough to prevent the onset of withdrawal are not sufficient to achieve the desired high. Suboxone abuse is achieved by sublingual use, because buprenorphine is readily absorbed that way, and naloxone is not. If crushed and injected, however, the naloxone becomes easily available and will prevent any high from the buprenorphine. Additionally, it will precipitate withdrawal in people under the influence of opioids, and — as mentioned above — buprenorphine itself can cause withdrawal in higher doses. That and its ceiling effect keep buprenorphine-based drugs from being highly regarded by addicts.

Suboxone is readily available via many doctors who specialize in “detox,” Sunrise does not recommend that route. Many of these doctors are insufficiently trained in dealing with addicts and addictions, and in the case of some unscrupulous physicians there may be a reluctance to refer patients to experts. Equally, Suboxone maintenance is rarely effective in the long run, especially in the case of addicts who were using large quantities of opioid drugs.

Sunrise Detox recommends medically-supervised withdrawal in a clinical setting, preferably followed by science-based inpatient treatment, including a firm grounding in relapse prevention and an introduction to the support groups that are an addict's best shot at maintaining long-term sobriety.