Suboxone is not Methadone

suboxone

Suboxone is not Methadone 

Due to experience with use of methadone in treatment of the same group of patients, confusion is common with the use of Suboxone as a tool in helping people with addiction to opiates. True, both drugs are opiates, i.e. morphine-like drugs and both drugs can be abused by those so inclined to do so, but that is where the similarity ends.  The success rate for use of methadone to escape addiction from drugs like heroin and oxycodone is dismal.  In proper settings under proper supervision methadone is effective in this regard, but the reputation for being a witch for the devil substitute is deserved. This is  not so for Suboxone. People can and do get off Suboxone. Two additional products are now available containing buprenorphine and naloxone-Zubsolv and Bunavail. Both have unique virtues and different dosing schedules. However, general comments about suboxone apply to these products as well.

Understanding Suboxone, Bunavail and Zubsolv

Suboxone, ( just like Bunavail and Zubsolv) is actually two drugs in one pill or film.  The first and only active ingredient, Buprenorphine, is a narcotic analgesic, which was originally released as a regular pain medication.  Buprenorphine in and of itself is a very effective pain medication.  The second component is naloxone, which does nothing if the medication is taken as directed.  If ground up, injected or snorted or when taken with other opiates, the naloxone component can precipitate withdrawal symptoms etc.  When the medication is taken as directed. The naloxone passes through the GI tract totally inactive.  Naloxone is there only as a deterrent to discourage abuse and as a safety factor.   Methadone does not come with a combined deterrent medication because of the risk of precipitated withdrawal.

Unlike other opiates and narcotics, buprenorphine does not cause as much tachyphylaxis and tolerance (loss of effectiveness of a given dose of the drug.)    So you don’t develop ever-increasing dose requirements etc.  Unfortunately people on methadone do have issues with ever increasing dose requirements and have much more difficulty tapering off the drug.

Another significant virtue of Suboxone is that patients are more alert and cognitive functions are not as compromised on Suboxone as compared to methadone.  This is related to the fact that, while very effective in treating and preventing withdrawal, Suboxone does not cause the patient to experience “the high” experienced with methadone and other opiates.  After induction with buprenorphine patients are able to return to work or school in just one day, and the drug allows some patients to be otherwise narcotic free in as little as one day. .

Because Suboxone is a long acting drug, there is less chance of abrupt onset of withdrawal symptoms when a dose is missed.  Therefore, when used as a tool to “detoxify” an individual, gradual reduction in dose to wean off of the drug is much easier than with the other opiates.  Thus, Suboxone can be used as an effective pain medication or as a tool to detoxify an addicted patient gradually on an out patient basis.  In our practice, we have another modification in management of patients that has allowed us to be successful in weaning them off Suboxone.  Empirically, envision the brain as being able to recognize changes in dose in percentages rather than milligrams. A decrease in dose from; say 16 mg to 8mg, is perceived by the brain the same as from 2mg to 1mg.  Both adjustments are a 50% decrease in the amount of medication the brain has become accustomed to.  Compounded buprenorphine in customized dosages and flavors allows us to reduce doses in smaller amounts (percentages) at variable intervals.  This has been a wonderful and refreshing change from experience with methadone or even propriety formulations of Suboxone.  Experience to date is early, but empirically, relapse rates appear to be better than with methadone as well.  For more information see  www.sickofpainmeds.com or go to www.wisemedicalcenter.com/medical-services/opiate-detox/ , or http://wisemedicalcenter.com/medical-services/probuphine-buprenorphine-implant-provider/. 

Maternal Opioid Dependency

Pregnant mothers who abuse heroin or certain narcotic painkillers during pregnancy cause their newborns great suffering during their first days and weeks of life. Heroin, oxycodone and similar drugs are known as opioids.  Opiate addiction is more prevalent in Georgia and the suburbs of Atlanta thanaddicted and pregnant most states. On March 31, 2015 U.S. Senator Bob Casey (D-PA) and Majority Leader Mitch McConnell (R-KY) introduced legislation to address the rise of prenatal opioid abuse and infants suffering from opioid withdrawal. The Protecting Our Infants Act would direct the Secretary of Health and Human Services (HHS) to develop recommendations for preventing and treating prenatal opioid abuse and for treating infants born addicted to opioids.  Also, the bill would encourage the Centers for Disease Control and Prevention (CDC) to work with states like Georgia to help them improve surveillance and data collection activities regarding this problem.

 

Nationwide, there has been a staggering 300-percent increase in the number of infants diagnosed with newborn withdrawal since 2000. Experts believe even more cases that go unreported.

 

Babies, the most innocent members of our society, can be spared the sufferings of opioid withdrawals.  Researchers estimate that more than one baby every hour is born in the United States dependent on drugs and suffering from withdrawals. This statistic is as anger provoking as it is heart-breaking. Children are the most innocent of our society, and we have to protect them,” Senator McConnell said.

The Protecting Our Infants Act is supported by the March of Dimes, American Academy of Pediatrics and the American Congress of Obstetricians and Gynecologists.

  Babies born to addicted mothers may have a condition known as neonatal abstinence syndrome.  These babies have serious withdrawal symptoms in the first few weeks of life when exposed to illicit or prescribed narcotics during pregnancy.   These infants have symptoms like irritability, high-pitched crying, tremors, seizures, poor feeding, diarrhea and vomiting.  Many cases go unreported and it may not be clear why these babies are suffering or they may be misdiagnosed to have other causes of irritability etc. The fluctuating drug levels can cause constriction of blood flow to the baby and result in spontaneous abortion (miscarriage), pre-term birth, or small for gestational-age babies.

Addiction to opioids such as prescription painkillers like oxycodone, hydrocodone, tramadol or heroin—is a challenging and complicated condition that can be treated effectively with medication-combined with counseling and support. If you are pregnant & if pain meds or heroin are ruining your life or affecting your family or threatening your job or business—get help getting off of them! CALL 770-680-2197 or visit: www.sickofpainmeds.com Do it for your baby!

Source:

http://www.casey.senate.gov/newsroom/releases/casey-mcconnell-introduce-bipartisan-bill-to-address-maternal-addiction-and-infant-opioid-withdrawal