Suboxone - things you may not know

Right away let's get this out of the way - even if you don't know what Heroin or Pain Pill looks like, you need to read this post. At some point you or someone you know will be effected by drugs so may as well know a little about it. Information is power and chaos comes from a lack of awareness. 

I should probably put that last sentence in a meme or something.

Ok, SUBOXONE! Let me give you a quick skinny from a Mental Health Therapist's point of view...by the way, I've been working in the field of addiction for years so this isn't coming from a completely ignorant point of view. I hear the word Suboxone 5 days a week.

What is Suboxone (often referred to as "Subs")? Great question - and easy to answer on the surface level which is where we're going to keep this blog. Subs are a combination of 2 other drugs combined; Bupenorphine and Nalexone.  But before we get into that, let'd do some 'brain talk'. Amongst a few million other things to talk about, our brain has receptors in them. Receptors open and shut allowing for certain feelings to be felt. An "ANTAGONIST" is a chemical that opposes or shuts down a receptor in the brain. An "AGONIST" activates certain receptors in the brain.

Ugh, I know - brain talk is so boring. And this is why I didn't become a brain doctor. Alright, lets talk Buprenophine (often referred to as "bup" pronounced "bupe"). Bup is an opioid derivative (imitation) that’s 25-40 times more potent...and lasts way longer than morphine (also an opioid). BUP is a 'partial' opioid ‘agonist’.  This means it ‘partially activates’ the opioid receptors in the brain. If full agonists are like wide open doors – bup is the opioid door only partially open. Same feel, just less…and it waaaay longer.

Next we have Naloxone. Now this stuff is legit. An Opioid ANTagonist It COMPLETELY BLOCKS the opioid receptors. Another term for this is“Narcan” – If you find someone that’s taken more opioids their body can tolerate you give them they go into OD (over-dose) which can cause death. Give them NARCAN and it immediately blocks the opioid receptors in the brain and saves people’s lives...and takes away the HIGH. Bye Bye, High.

Side note – you have to be clean at least 3 of days before taking subs – otherwise you get sick.

What is Suboxone? It's an actual opioid receptor blocker (antagonist) combined with a 'partial' opioid receptor activator (agonist). I know I know, why didn't I just say that in the beginning? 

Other things to know about Suboxone - Sub withdrawals PEAK after 6-8 days and can last up to a month or longer! Remember, the BUP is longer lasting so it takes the brain longer to get rid of it vs a heroin detox taking around 4 days to peak and then you're back to life after 7 days. Because of the detox being so significantly LONGER you may be recommended to take a FULL YEAR in order to TAPER from subs by your doctor. AND just like HEROIN, the more you’re doing and the longer you’re on it, the longer it takes to withdraw. And not all dr's can prescribe Suboxone! I'm not positive on this but I think that to start off, a Dr. will only be able to have a very limited amount of clients on suboxone...10 or 15 maybe? Then the next year they can apply and have more allowed and then the next year the number can grow - not sure what it tops out at but when I worked at a suboxone clinic, the Dr. saw people all day long 2 times a week. 15 minute sessions. 250.00 per appointment.  

Expect a few hours max to feel ‘normal’ when on subs. After that, you’ll get tired and groggy.
In a lot of ways, you are trading one chain for another chain. It isn’t being ‘clean’ – it’s doing a drug that’s more socially acceptable and less likely to kill you quickly. You can still Over Dose on SUBS.

I’m not here to debate medication use for opioid dependence - I’m here to be honest and reflect what I observe and here’s what I have observed while working in the addiction field for years – and by all means, I AM NOT GIVING MEDICATION ADVICE – just reflecting what I’ve observed like a good therapist.

And here's what I want to be the LOUDEST reflection for you - ​I’ve witnessed more people go into recovery and STAY in recovery without the use of subs than I have with the use of SUBS. The sub maintenance plan seems to come back more often for more rehab. No Sub Dr. will tell you that. Rather, they'll say that you're LESS likely to remain sober without subs. I've heard it. And it's not what I've seen. 

Treat detox like a bandaid - RIP IT OFF! Have support and a good treatment team there to assist when you need but for the love, just get the withdrawals over with so you can start doing the tough stuff...like facing all those emotions you cover up with drugs.

Thanks for reading,
Jed Thorpe, CMHC