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What Is Suboxone Prescribed For?

Suboxone is prescribed to treat opioid use disorder (OUD).

What is Suboxone?

Suboxone is a Food and Drug Administration (FDA) approved Medication for Addiction Treatment (MAT) used to treat opioid use disorder (OUD). 

Before Suboxone, methadone therapy was the medication of choice for treatment of OUD. However, there were many barriers to its use, including the fact that legally it can only be distributed through a methadone facility, requiring a patient to arrive daily to receive their medications. In 2000, the Drug Addiction Treatment Act (DATA 2000) approved Suboxone  to treat opioid dependence, which can be prescribed by any clinician with a waiver, greatly expanding access to treatments for OUD. [1]

Who Can Prescribe Suboxone?

Up until recently, treatment providers needed to complete additional training and obtain a “waiver” in addition to their regular medical license in order to prescribe suboxone; however many states have recently eliminated that requirement.  Once prescribed, you can pick up Suboxone from your local pharmacy. Unlike methadone, you do not need to go to a specialized clinic to get it. This greatly expands access to MAT for patients with OUD.

Suboxone is a safe and effective medication for treating OUD on an outpatient basis.

Which Substances Can Suboxone Help Treat?

Suboxone can be used to help treat symptoms of withdrawal from any of the opioid class of medications, which include:

Prescription Opioids

These opioids come in pill form and are mainly used for pain-relief. They include medications like oxycodone, hydrocodone, and morphine. These drugs can cause physical and psychological dependence even if taken as prescribed by a doctor, particularly in patients that have been using them for an extended period of time [4]. They work the same way as heroin by binding to opioid receptors in the brain. Even when taken as directed, prescription opioids may need to be tapered off slowly to avoid uncomfortable withdrawal symptoms.

Heroin

This highly addictive illicit opioid is fast acting and rapidly binds to opioid receptors in the brain, causing an intense euphoria or “high.”[3] Heroin addiction involves both physical dependence, related to changes in brain chemistry caused by the drug, and behavioral modifications, including mood swings and drug-seeking actions. Heroin is an extremely dangerous illicit substance. 

Fentanyl

This is one of the most potent and potentially dangerous opioid drugs. Fentanyl that is produced synthetically and then sold illegally has the potential to be anywhere from 80 to 100 times stronger than morphine.[5] Because fentanyl that is purchased illegally is unregulated, its potency can be highly variable, greatly increasing the risk of accidental overdose.

Fentanyl quickly enters the bloodstream and binds tightly to opioid receptors in the brain.

Suboxone, especially when used to treat heroin or fentanyl addiction, can be a lifesaving medication. It can help prevent overdose by switching to a less potent and partial opioid agonist that will not create the high (or the same level of sedation and respiratory depression) while still activating the receptors to an extent to keep cravings and withdrawal symptoms at bay.

Are There Other Uses of Suboxone?

Suboxone is FDA-approved for MAT in the treatment of OUD. Buprenorphine is also a partial opioid agonist. As a result, it is also used, albeit off label, as a pain reliever medication. It is still a powerful pain relief medication, but can be a great option for patients for whom non-opioid medications are insufficient or not tolerated, or if patients are seeking to discontinue long term use of full opioid medications. 

Overall, Suboxone is a safe and efficacious medication used by thousands of people all over the United States for the treatment of opioid use disorder. If interested in learning more about suboxone, talk to your doctor. 

SOURCES

  1. Statutes, Regulations, and Guidelines. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines#DATA-2000. December 2021. Accessed January 2022.
  2. Buprenorphine. Substance Abuse and Mental Health Services Administration (SAMHSA). https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine. May 2021. Accessed January 2022.
  3. What Is Heroin? National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/publications/drugfacts/heroin. June 2021. Accessed January 2022.
  4. Opioids. National Institute on Drug Abuse (NIDA). https://www.drugabuse.gov/drug-topics/opioids. Accessed January 2022.
  5. Fentanyl. Drug Enforcement Agency (DEA). https://www.dea.gov/factsheets/fentanyl. Accessed January 2022.
  6. Anxiety Treatment of Opioid Dependent Patients with Buprenorphine: A Randomized, Double-Blind, Clinical Trial. Indian Journal of Psychological Medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5559992/. July–August 2017. Accessed January 2022.

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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