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Are all patients a good fit for Suboxone treatment?

Medications (along with behavioral therapy) are an important part of treating opioid addiction and helping patients stay in recovery. Compared to being on medications for opioid addiction treatment, patients NOT on medications are more than 3 times likely to die from an opioid overdose. The three scientifically-proven medications to treat opioid addiction include: buprenorphine/naloxone (Suboxone), methadone, and vivitrol. Each work slightly differently and the choice to be one versus another really comes down to patient preference. 

Buprenorphine/naloxone (Suboxone) is convenient in that it can be prescribed in an outpatient setting and does not require daily trips to methadone clinics; though, some people need that level of accountability. Unlike methadone, Suboxone has very few medication interactions, and has a ceiling effect (taking more and more does NOT result in an overdose or getting “high”) so it is very difficult for patients to overdose on it. It is considered to be a very safe medication. Vivitrol is a third effective option provided as a monthly injection that is available in the outpatient setting too. 

When taken appropriately, all these medications should help patients avoid feeling cravings or withdrawals from opioids, block other opioids (like heroin or fentanyl or oxycodone), and help patients feel normal so they can get back to a meaningful and fulfilling life.

The decision of which medication to choose is ultimately an individual one. Since Suboxone is very safe and convenient with almost no contraindications, many people prefer this option. 

Bottom line: Patients with opioid addiction who are motivated to be in recovery and desire treatment with Suboxone are considered good candidates. 

Randi Sokol, MD, MPH, MMedEd

Randi Sokol, MD, MPH, MMedEd, is an Assistant Professor at the Tufts Family Medicine Residency Program and Instructor at Harvard Medical School. She is Board Certified in both Family Medicine and Addiction Medicine. She earned her B.A. at the University of Pennsylvania, her Medical Degree and Masters in Public Health from Tulane University, completed Family Medicine Residency at UC-Davis, and earned a Masters in Medical Education through the University of Dundee.

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