Is Suboxone Really Just ‘Trading One Addiction for Another’?

October 17, 2022

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Suboxone isn’t “trading one addiction for another.” It can effectively help people quit misusing opioids. The available evidence on Suboxone treatment shows repeatedly that Suboxone is a highly effective treatment for OUD. 

Suboxone Treatments Are Evidence-Based

The treatment of OUD has been hampered by stigma. Critics of MAT argue that Suboxone and other medications are just “substituting one addiction for another”.

This is a myth and is highly counterproductive. The assertion that Suboxone treatment is just “trading one addiction for another” is an unfortunate stereotype that perpetuates stigma around OUD and makes recovery more difficult for those seeking treatment.

Suboxone treatments are evidence-based and have undeniably helped thousands of people overcome opioid misuse. [1] It is considered by many professionals to be a life saving medication. 

What is Suboxone?

Suboxone combines two medications, buprenorphine and naloxone.[2] Buprenorphine is an opioid partial agonist, producing an effect that is similar but milder than full opioid agonists like heroin. When Suboxone is in your system, it reduces cravings for full opioid agonists by binding to those same opioid receptors in the brain. 

Efficacy of Suboxone for OUD

Suboxone as  MAT helps to reduce risk of relapse as well as overdose.[3]In contrast, abstinence-based models have relapse rates as high as 90%.

Suboxone has been shown to have the following benefits:

  • Reduce the risk for fatal opioid overdose
  • Lower the risk for contracting and transmitting infectious diseases, such as hepatitis C and HIV/AIDS
  • Reduce criminal activity
  • Increase treatment retention and social functioning
  • Better outcomes for babies born to mothers with opioid use disorder
  • Decreased opioid use
  • Better ability to gain and maintain employment

Can You Become Addicted to Suboxone?

There isn’t much data supporting the idea Suboxone is particularly “addictive” in the traditional sense, although it can cause physical dependence that may result in withdrawal symptoms if you suddenly stop taking it.

To help prevent withdrawal, Suboxone is generally tapered slowly with the advice/assistance of a doctor. [4]

Is It Possible to Misuse Suboxone?

It is possible to misuse Suboxone, as it can produce a sense of euphoria in opioid-naïve users, even if it is much milder than that associated with the misuse of full opioid agonists.

Because Suboxone contains Naloxone, if you misuse it by injecting it, the Naloxone blocks the “high” feeling, and prevents misuse by injection and the risk of overdose. For this reason, it is hard to “misuse” Suboxone, at least by injecting it. It is also always possible to take more than your prescribed dose. However, suboxone has a “ceiling effect” in which it does not continue to get a person more ‘high” even at higher doses, which also lessens its potential to be misused. For these two reasons, Suboxone has a much lower misuse potential than other MAT treatments like Methadone. [5]

The bottom line:

The assertion that Suboxone is just “trading one addiction for another” is an outdated and stigmatizing way of thinking about appropriate treatment for OUD. If you are interested in Suboxone therapy and think it might help to improve your quality of life, don’t let misconceptions or bigotry get in the way of getting the treatment you need. Reach out to your doctor or to Bicycle Health to learn more about Suboxone and if it might be right for you.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. 5 Myths About Using Suboxone to Treat Opiate Addiction. Harvard Health Publishing. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496. October 2021. Accessed September 2022.
  2. Buprenorphine. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. July 2022. Accessed September 2022.
  3. Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. 2018. Accessed September 2022.
  4. Buprenorphine Tapering Schedule and Illicit Opioid Use. Addiction. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150159/. February 2009. Accessed September 2022.
  5. Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review. Current Drug Abuse Reviews. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3154701/. August 2011. Accessed September 2022.

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