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Suboxone Abuse and Addiction: An In-Depth Guide to This Addictive Recovery Med

While Suboxone (buprenorphine) has come onto the addiction scene as the new gold standard when it comes to treating opioid dependency, Suboxone abuse and addiction can in fact be a very serious problem.

Becoming addicted to this sneaky opioid can have devastating consequences to your physical health, your mental well-being, and even your life as a whole. 

That’s why it’s so important to educate yourself about the ins and outs of this drug. What is Suboxone? What is it used for? How is it being abused and causing addiction today? 

And perhaps most importantly, what does it take to fully recover from a Suboxone addiction once you’ve developed one?

This comprehensive guide on Suboxone abuse and addiction will answer these questions and more. It’s an all-in-one look at how Suboxone, despite its benefits in the addiction field, can actually become a particularly dangerous substance of abuse. 

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What Is Suboxone?

Before diving into the signs of Suboxone abuse, let’s take a quick look at what this drug really is.

Suboxone is a medication currently used to treat the painful symptoms of withdrawal caused by opioid dependency. It’s manufactured exclusively by a pharmaceutical company called Reckitt Benckiser and, historically, came in two forms: a sublingual tablet and a sublingual film.

The tablet version of this drug has since been taken off the market by Reckitt Benckiser (a choice that’s been embroiled in controversy) but a number of generic versions have since been released including Bunavail and Zubsolv released in 2013 and 2014 respectively. Bunavail comes as a dissolvable buccal film (meaning it’s placed on the inside of your cheek) while Zubsolv is a sublingual tablet meaning its absorbed under the tongue. 

On a chemical level, Suboxone was widely considered to be one of the most promising new medications used to treat opioid dependency. It contains the partial opioid agonist buprenorphine along with the opioid antagonist naloxone.

Working together, these two compounds help reduce the severity of cravings in recovering addicts, eliminate withdrawals when used correctly, and can even block some opioids from producing the sedation and euphoria that they’re abused for.

Subutex is another drug similar to Suboxone. However, while Suboxone has the added anti-abuse chemical naloxone, Subutex is composed solely of buprenorphine. As such, it tends to be more susceptible to abuse than Suboxone and is one of the reasons the drug has since been removed from the market.

There’s never been a direr need in our country for addiction treatment reform than there is today. From May 2016 to May of 2017, an astounding 66,324 people died from a drug overdose in the U.S according to the National Center for Health Statistics.

These numbers are a shocking change from almost two decades ago. In 1999, the number of confirmed drug overdoses was fewer than just 17,000. That’s an almost fourfold increase over just 18 years.

And unsurprisingly, opioids are the main culprits in this unprecedented rise in overdose deaths. With the rise of purportedly safe prescription painkillers like OxyContin and Percocet along with unbounded opioid prescribing guidelines and pharmaceutical industry marketing, more and more Americans grew addicted to these overpowering drugs.

These weren’t just people looking for a quick buzz either. Opioids can be incredibly addictive, even when they’re used according to a legitimate prescription. The Centers for Disease Control and Prevention actually found that 1 in 4 patients who receive long-term opioid prescriptions for non-cancer pain actually struggle with addiction.

What’s more, prescription opioids can also be deceptively powerful. Fentanyl, a synthetic opioid used in clinical pain management, is as much as 100 times stronger than morphine and even 50 times more potent than heroin.

It’s no wonder, then, that Fentanyl is now responsible for more deaths than heroin.

Clearly, both natural and synthetic opioids are a problem. And if we’re ever going to fix it, we need better addiction therapeutic methods that are proven to be more effective than the old way of treating a dependency issue.

And that’s why Suboxone, one of the most effective opioid dependency treatment medications, has become so important in the addiction world today.

Signs of Suboxone Abuse

Despite being one of the best chances for opioid addicts to get past their painful withdrawals, overcome cravings, and remove the incentive for relapsing, Suboxone is by its very nature an addictive drug itself.

That’s why learning how to identify the signs of Suboxone abuse is so crucial. The more able you are to pick out the symptoms of abusing Suboxone in others, the faster you can get them the professional help they need before it turns into an addiction.

In order to understand how and why Suboxone is abused, it’s necessary to understand a bit more about the chemical compounds that make up this particular medication.

Buprenorphine is the main star of this medication as it’s responsible for the reduction of cravings, lessening of withdrawal symptoms, and even for blocking other opioids from latching onto opioid receptors. And best of all, it isn’t nearly as addictive as other drugs.

Buprenorphine is able to accomplish all this because it is a partial opioid agonist. That means that it binds to the opioid receptors in your brain (the same ones that drugs like heroin bind to) and stimulates them to a lesser degree than other opioids that are full agonists. That’s where the “partial” comes into play in “partial opioid agonist.”

What’s more, buprenorphine is also what’s known as a “sticky molecule,” meaning it has an especially high affinity for these receptors. That means that it tends to be more attracted to these cells and when it does bind, it isn’t likely to come off, thereby blocking the receptor entirely. It can even knock off other opioids from these receptors. That’s how powerful it is.

As a result, detox is less of an overwhelming experience and relapsing is not only less likely but also just plain harder to do (since it literally blocks the receptors).

The second ingredient in Suboxone is not quite as active as buprenorphine but, according to some, it can be just as integral.

Naloxone is an opioid antagonist meaning it blocks off the opioid receptors (like buprenorphine) without actually activating it. Also similar to buprenorphine, naloxone has an especially high affinity for opioid receptors and consequently, can knock of certain other opioids from those receptors too.

But naloxone isn’t just any opioid antagonist. Rather, it’s what’s also known as a partial inverse agonist. That means that it can actually reverse the effects of opioid agonists that attach to the receptors.

This quality in particular makes it especially useful during a potentially fatal opioid overdose. When someone suffering from decreased respiration caused by opioid overdose is treated with naloxone, their respiration can return to normal within minutes.

One side effect of using naloxone in someone with opioids in their system though is that doing so can bring on a precipitated state of opioid withdrawal – the symptoms of which can be excruciating at times.

Now, the reason this compound is included in Suboxone is that it works as an abuse deterrent. When Suboxone is taken properly (either orally, sublingually, or via buccal film), the naloxone remains inactive naturally. If it didn’t, it would react with the buprenorphine and cause precipitated withdrawal.

However, if Suboxone is abused via injection or intranasally by snorting, the naloxone does in fact interact with the buprenorphine and bring about the incredibly uncomfortable symptoms of withdrawal.

This makes Suboxone particularly hard to abuse but, as we’ll see, that doesn’t stop some people.

While Suboxone is much safer and less habit forming than methadone, another opioid agonist used in treating opioid dependency, it can still be abused in order to achieve a high.

Compared to other drugs, however, figuring out exactly how to do so can be a bit tougher. That’s because Suboxone is manufactured with a powerful abuse deterrent (naloxone) built right into the compound. As a result, opioid addicts can’t simply melt Suboxone down and inject it or even crush and snort it without feeling some pretty nasty side effects.

What’s more, buprenorphine itself also has what’s known as a “ceiling effect,” meaning so much buprenorphine up to a point can cause euphoria and sedation. But once that ceiling is reached, you won’t be able to feel any added effects, no matter how much more you take. This is another reason Suboxone is considered so much safer than its alternatives.

These factors all add up to a highly abuse-resistant drug, so much so that it can even be prescribed in a physician’s office rather than distributed via an approved clinic (the only way to receive treatment via methadone).

That being said, these factors also make it significantly easier to get your hands on Suboxone and, most importantly, use it outside of the supervision of the prescriber. With Suboxone, patients can take their dose within the confines of their own home. But with that added level of freedom, they can also find different ways of abusing this drug that its numerous safeguards aren’t able to prevent.

In fact, in 2011 alone more than 21 thousand people were admitted to the emergency department for nonmedical use of buprenorphine. Evidently, drug users are finding a way to abuse this substance.

Methods of Suboxone Abuse

Despite Suboxone seeming like a perfect drug that’s near impossible to abuse, users have found a few ways to take advantage of this deceptively dangerous opioid.

Let’s take a look at how.

For one thing, mixing Suboxone with other drugs can be quite common when it comes to abusing this substance. While most people avoid using Suboxone with other opioids as it is highly likely to cause precipitated withdrawals, the buprenorphine in Suboxone can actually intensify the sedation and euphoria from other central nervous system (CNS) depressants like alcohol, barbiturates, and benzodiazepines

What’s more, Suboxone may also be combined with other illicit substances such as marijuana. 

Data from the Drug Abuse Warning Network (DAWN) report sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA), found that the overwhelming majority of emergency department visits involved abusing other substances as well, most notably other pharmaceuticals like benzodiazepines (27%), illicit drugs (also 27%), and alcohol (11%). 

Some drug users may also take advantage of a Suboxone prescription in order to stave off withdrawal symptoms simply to tide them over until their next serious opioid fix. Heroin users, for example, may use Suboxone throughout the week in order to hold up a job and maintain appearances, only to come off the drug so they can get high over the weekend. 

Suboxone, then, isn’t helping them get clean but rather is supporting their drug habit in general. 

And finally, users can also take multiple doses of buprenorphine at once, though the maximum effect of doing so is hindered by the drug’s ceiling effect. However, users with a particularly low opioid tolerance can in fact achieve some degree of sedation and euphoria before this ceiling is actually reached.

How Can You Tell If Someone Is Abusing Suboxone?

Just like any other opioid or substance of abuse, misusing Suboxone can lead to the development of a variety of damaging health effects and even a crippling addiction if left untreated. That’s why it’s so important to know how to spot the signs of Suboxone abuse.

Whether it’s a family member, a close friend, or even just an associate, sometimes the only thing holding a person back from getting the help they need is simply someone else pointing out that they know there’s a problem.

The signs below will help you spot Suboxone abuse before it’s too late.

Signs of being high on Suboxone include:

  • Extreme drowsiness (e.g. nodding off during conversations)
  • Poor memory (e.g. losing track of a what they were just saying)
  • Poor coordination (e.g. tripping over furniture)
  • Elated mood
  • Small pupils
  • Slurred speech
  • Nausea or vomiting

Whether it’s a significant increase in sick days at work, numerous missed classes, or simply the fact that they’re not really around as much as they used to be, if your friend or family member has a lot of time left unaccounted for, it could be that it’s being spent getting high on Suboxone.

As strange as it sounds, a substance abuse problem takes dedication. It requires an enormous amount of time seeking out the drug and even more to take it and recover from its effects. As such, substance abusers will often sacrifice other aspects of their lives to devote more time to their drug habit. As a result, they may have worse personal hygiene, a dramatically different weight, and they might even put less stake into how they dress as well.

A drug habit is also expensive. And given the numerous financial problems a Suboxone abuser is likely to encounter thanks to their drug use, they might resort to stealing either money or personal possessions from their friends and loved ones. So, be on the lookout.

These are just a few of the signs of a Suboxone abuse problem (and there are more). If you notice these signs and your gut is telling you that something simply isn’t right, it may be time to get them to see professional help.

When dealing with Suboxone abuse, whether it’s on a personal level or involving friends or loved ones, it’s important to realize that misusing this prescription drug can have a number of pretty severe short- and long-term effects.

According to Drugs.com, the most notable short-term effects of using and abusing Suboxone include:

  • Abdominal pain
  • Constipation
  • Lack of strength
  • Nausea
  • Pain
  • Insomnia
  • Vomiting
  • Diarrhea
  • Sneezing
  • Fever or chills
  • Flushing skin
  • Sweating
  • Headache
  • Dizziness

In the long-term, Suboxone can also have a number of other physical effects as well. As with most opioids, continued Suboxone abuse can cause a variety of gastrointestinal issues like recurring constipation, nausea, and vomiting. This is because the GI tract is one area of the body with an especially high number of opioid receptors that Suboxone ends up binding to.

Frequent Suboxone abuse may also lead to what’s known as Opioid-Induced Hyperalgesia, also known as OIH. This condition is marked by a counterintuitive increase in pain sensitivity after using opioids for a period of time. Studies are still being conducted on how exactly this process works but researchers believe it has something to do with glutamate receptors in the brain.

It should be noted that buprenorphine in particular has far less of a risk of causing OIH but has been shown to occur in some studies.

The effects of Suboxone abuse aren’t only physical either. In fact, continued opioid abuse has been linked with a decrease in the brain’s white matter. As a result, frequent Suboxone use could lead to problems with decision-making, behavior control, and responses to stressful situations.

And finally, continued Suboxone abuse also increases the chances of developing an addiction to the drug, the consequences of which can be especially life-altering and devastating.

One of the most devastating consequences of continued Suboxone abuse is an increased risk of overdosing on this dangerous substance. The most common cause of a Suboxone overdose comes from mixing it with other substances like alcohol, benzodiazepines, or illicit substances like marijuana or cocaine.

This danger is especially prevalent when combined with other CNS depressants as doing so can lead to dangerously low levels of respiration.

Also, while buprenorphine naturally has a ceiling effect, taking too much Suboxone alone can also result in a deadly overdose for patients who do not have a high opioid tolerance. For them, a deadly level of buprenorphine can be much lower than this ceiling effect. Suboxone, then, should not be used in patients with a relatively recent or mild abuse problem.

In short then, while buprenorphine is touted as being incredibly safe, abusing this powerful drug can in fact be quite dangerous.

Knowing what to do in case of a Suboxone overdose can end up saving a life. That’s why being able to spot the signs is so important, especially as Suboxone becomes an increasingly popular addiction treatment.

If you think someone is going through a Suboxone overdose, call the Poison Help hotline (1-800-222-1222) or call 911 if the individual has collapsed or is not breathing. 

Signs of a Suboxone overdose according to MedlinePlus include: 

  • Pinpoint pupils
  • Extreme drowsiness
  • Dizziness
  • Blurred vision
  • Slowed breathing 

Medscape, an online point-of-care drug and disease information resource for physicians, also points out that additional symptoms may include:

  • Lethargy
  • Vomiting
  • Agitation
  • Coma

When severe, the depressed respiration common with Suboxone overdose can lead to death. As such, it’s incredibly important that you contact emergency services as soon as possible. Every second counts when it comes to treating an overdose on Suboxone.

Suboxone Addiction

Suboxone abuse is associated with a host of detrimental health effects to be sure, but one of the worst is the development of an actual addiction to this opioid medication.

Affecting individuals on both a physical and psychological level, a Suboxone addiction can dramatically change the course of an individual’s life – so much so that they may alienate friends and family in the process while also abandoning a hard-earned career as well.

That’s why it’s so important to know precisely what’s involved in a Suboxone addiction as well as some of the signs of its development. This knowledge will not only help you avoid falling down the rabbit hole of dependency but will also aid in determining when it’s time for you to actually get professional help.

As an opioid agonist, Suboxone use and abuse does carry with it the risk of developing an actual addiction. Over time, the body and mind both become physically altered in such a way that normal functioning is impossible without the continual presence of Suboxone.

What’s more, a Suboxone addiction leads to the formation and reinforcement of drug-seeking behaviors which an addict simply can’t control.

The National Institute on Drug Abuse describes the condition as a “chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”

As you can see, addiction is considered to be an actual disease. This point can be a bit hard to swallow for some people. They argue that addiction is simply a choice – a moral failing that results from a lack of willpower, respect for others, and even a lack of respect for themselves.

But the truth is numerous agencies around the world know that addiction is far more than just a culmination of a series of bad choices. These agencies include:

And while “the initial decision to take drugs is typically voluntary,” writes NIDA, “with continued use, a person’s ability to exert self-control can become seriously impaired.”

It continues, “Brain imaging studies of people with addiction show physical changes in areas of the brain that are critical to judgment, decision making, learning and memory, and behavior control.”

One common misconception about addiction is that it is synonymous with physical dependence. And while there is undoubtedly a physical aspect to addiction on a biological level, these two terms are actually describing separate conditions.

To explain, physical dependence develops when the body gets so used to a drug like Suboxone being consistently present that it actually begins to adapt on a physical level. For opioids like Suboxone in particular, that means that your body and mind may start to downregulate (i.e. kill off) some of your opioid receptors, making it harder to achieve a high.

As a result, you start to build up a tolerance to the drug, meaning you must take higher amounts of Suboxone to get the same feeling as before.

When the drug is removed from an addicted system’s use patterns though, it can’t function normally for a period and must adapt by reversing these physical changes. The result of this process is often an onslaught of especially uncomfortable physical and mental symptoms.

These are what are known as symptoms of drug withdrawal.

Experiencing tolerance and withdrawals are the two main criteria for a physical dependency.

Addiction, on the other hand, is more about a pattern of compulsive, drug-seeking behaviors. Physical dependence isn’t always necessary for an addiction, but it is incredibly common among addicts.

For instance, though chronic pain is highly associated with addiction, a patient taking prescription opioids can be physically dependent on painkillers if they experience tolerance and withdrawal. But unless they exhibit compulsive, drug-seeking behaviors, they wouldn’t be considered addicted.

Three Core Components of Addiction

There are three main qualities that characterize an addiction rather than just a physical dependency.

An inability to control one’s own behaviors is one of the hallmarks of addiction. Through continued stimulation of key decision-making pathways in the brain, an addict is compulsively driven to seek out drugs, whether they like it or not. Repeated failed attempts at quitting, a desire and inability to slow down, and a lack of self-control when it comes to overusing are just a few examples of this component of addiction.

Though this aspect is not necessarily required in order for a condition to be considered addiction, the two quite frequently go hand-in-hand. A rising tolerance to a drug often leads individuals to seek out more and more of the addictive substance. And if this behavior isn’t curbed early on, it can often lead to the development of the other conditions that characterize addiction.

Not to be confused with just intoxication, impairment in this sense means that an addict will continue their abuse despite knowing the negative consequences that abuse will bring. This could mean alienating friends and family, frequently missing work or school, or putting themselves in physically dangerous situations (e.g. unprotected sex, driving under the influence), all because of their substance abuse.

Developing an addiction to Suboxone can drastically change your life for the worse. And while most people recognize that fact on a fundamental level, they may not truly realize the harm that an addiction can cause.

So, what’s really at stake if you’ve developed an addiction to Suboxone?

  • Persistent & Dangerous Health Effects – One of the most commonly cited reasons for avoiding addiction, your physical and mental health are two areas where you likely stand to lose the most. Not only does a Suboxone addiction mean you’ll probably undergo a host of short-term side effects, you may even suffer permanent brain damage as a result.
  • Social Alienation – The impact an addiction can have on friends and family can be staggering. It be incredibly hard to rebuild the trust that the constant lying and manipulation of addiction can lay waste to. And if you’re like many addicts, you won’t learn that fact until after it’s too late.
  • Financial Ruin – An addiction to Suboxone can be pricey, especially when you take into account the impact it can have on your job. Beyond that, addiction also tends to push aside other obligations as well. Consequently, you may end up defaulting on credit cards, mortgages, and other financial duties.
  • A Permanent Legal Record – There is a strong correlation between addiction and crime. Whether you’re getting your hands on Suboxone illegally, are putting yourself in legally questionable situations, or are getting behind the wheel under the influence, an addiction to Suboxone increases the likelihood that you’ll have run ins with the law. And that could mean trouble for your criminal record.
  • Loss of Self – Last but not least, an addiction fundamentally changes how you think and act on a fundamental level. Your mood, ability to reason, personality, and even morality can all change dramatically once you’ve developed an addiction to Suboxone. And that might mean you’ll lose sight of who you were before it.

Suboxone and its past producer, Reckitt Benckiser, has been embroiled in a bit of controversy recently.

Today, the sublingual tablet version of Suboxone has been removed from the market due to what Reckitt Benckiser claims are concerns over exposure of these pills to children. However, the pharmaceutical company has since been sued by 35 U.S states who argue that Reckitt Benckiser was engaged in a multi-pronged profiteering scheme that sought to control the market by eliminating generic competition.

After being the sole producer of products containing a buprenorphine and naloxone combination for seven years (awarded to them based on their research and development of the powerful combo), Reckitt Benckiser allegedly increased their tablet prices to manipulate patients into switching over to the sublingual film form. This all happened, of course, right before their exclusive rights to the compound were set to expire. 

Once the majority of patients had switched over, they then brought a case to the Food and Drug Administration (FDA) claiming that the pill version of this compound was unsafe for children. The aim here was to deem pill versions of generic Suboxone as unsafe and, thus, solidify Reckitt Benckiser’s hold on the market.

The FDA did not rule in Reckitt Benckiser’s favor, however, but by then, the damage was done, and most patients had already converted to the sublingual film version. Reckitt Benckiser has since sold off Suboxone manufacturing to another company and in 2017, the case against the manufacturer brought up by 35 states was ultimately dismissed.

The takeaway from all of this isn’t cut and dry. The allegations against Reckitt Benckiser were never verified in a court of law and in the end, there was no proven wrongdoing.

However, it just goes to show that even though these medications are helping countless recovering addicts stay off of life-threatening drugs like heroin, pharmaceutical giants from all sides of the opioid epidemic just might be profiting from this nationwide health crisis.

One of the biggest barriers to getting treated for an addiction is the continuous and persistent denial that so often comes with substance abuse.

This probably isn’t much of a surprise to you. After all, who hasn’t seen the old trope of an intoxicated drug addict insisting that they don’t have a problem? But the true extent of how much of a problem denial poses for treatment might be a bit more dramatic than you think.

According to data from the National Survey on Drug Use and Health (NSDUH) conducted by SAMHSA, a whopping 20.2 million Americans were classified as needing substance use treatment but did not receive it. Of those 20.2 million in need of treatment, only 4.5% of them thought they had an actual problem.

That’s about 19.3 million people who didn’t receive treatment because they couldn’t admit to themselves that they were addicted.

Denial and addiction, then, tend to go hand in hand.

Part of the reason for this shockingly strong association is the fact that addiction fundamentally alters the way we think, both about ourselves and about the world around us. Drug-seeking behaviors become much more highly prioritized than others because they end up flooding the brain with more dopamine.

And when those behaviors are called into question and ultimately threatened by acknowledging the addiction, your brain has been conditioned to deny that reality.

Developing an addiction leads to a kind of vicious cycle then – the more an individual becomes addicted to a substance, the more they’re predisposed to denying they have a problem at all.

Spotting the Signs of Your Suboxone Addiction

Given just how difficult it can be to admit that you’re struggling with an addiction to Suboxone, it’s critical to your health and safety to learn how to recognize the signs of a Suboxone use disorder early on. Because as you know, the more addicted you become, the less likely you’ll be to admit you have a problem.

This is easier said than done though.

One of the best ways to do so is by objectively evaluating your specific behaviors rather than relying on a gut feeling. This tactic can be instrumental in helping you circumvent the inherent bias for denial that your addiction has likely created.

There are four main methods of doing so.

The first method is by taking a quick online addiction quiz to get a solid idea of whether you exhibit the signs of a Suboxone use disorder. It doesn’t take long to complete, and it might be just the push you need to start looking for professional help.

You can also take advantage of the numerous self-assessment tools provided by NIDA. These tools vary in complexity from just a few questions all the way to multi-tiered result pathways that cover numerous substances of abuse. The majority of these tools are free to use but there are also paid options as well.

For an even more in-depth self-assessment, you can also use the clinical guidelines set out by the Diagnostic and Statistical Manual of Mental Disorders (5th Edition). These 11 scenarios are used by licensed physicians and psychiatrists across the country to diagnose a substance use disorder. If a patient confirms that they’ve experienced at least two of the scenarios in a 12-month period, they likely have a problematic pattern of Suboxone use. You can take a look at these guidelines through the National Institute on Drug Abuse’s page.

And finally, you can also reach out to an expert addiction center for a free phone assessment. These phone calls only take about 20 to 30 minutes and are conducted by a professional and supportive addiction specialist. They’re 100% confidential, zero-obligation, and are one of the best ways to get answers tailored specifically to you.

Suboxone Crime and Punishment

Suboxone Crime & Punishment

While Suboxone is in fact a 100% legal drug when used according to a doctor’s prescription, abusing Suboxone and other buprenorphine drugs as well as using them to facilitate criminal activity can carry some pretty harsh legal penalties.

Before getting into the maximum federal penalties for Suboxone-related crimes like possession, trafficking, and more, it’s important to understand why Suboxone and prescription drugs in particular have a much different relationship with the law compared to illicit drugs.

Addiction, Legality, & Prescription Drugs

Prescription medications like Suboxone have an interesting relationship with addiction, namely because by themselves, they are not necessarily illegal to use. In contrast to drugs like heroin, cocaine, or marijuana, you can take Suboxone without fear of legal retribution, so long as you have a prescription.

Suboxone Addiction Information

This characteristic about Suboxone and prescription drugs in general can cause a bit of confusion in the public about just how dangerous these medications can really be. After all, Suboxone comes from a doctor – so how could it be dangerous, or even illegal?

And it’s true, prescription drugs in general can be quite safe. In fact, almost 50% of Americans take at least one prescription drug while more than 1 in 10 take five or more prescription drugs. But just because prescription drug use is common doesn’t mean it’s safe.

The truth is that these drugs can be exceptionally powerful and deadly – more so than most people may know. One estimate concluded that taking prescription drugs is the fourth leading cause of death in the United States, and that’s not including deaths from prescribing errors, overdose, or self-medication.

And when you add in the enormous number of daily emergency department visits caused by abusing prescription opioids like Suboxone (1,000 per day), it seems clear that prescription medications are deadlier than you likely suspect.

Plus, given that an alarming 60% of Americans simply don’t follow their doctors’ orders when taking prescription medications, these drugs can be especially dangerous.

So, while most people may think that illicit substances are more powerful than prescription medications, the truth is that many of these clinical drugs actually kill more people a year than their illicit counterparts.

Suboxone is classified as a Schedule III narcotic, a status which the Drug Enforcement Administration defines as:

drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV.

Below are some examples of the various DEA schedules along with some drugs that fall under these classifications.

As you can see, Suboxone is considered to be more dangerous in addiction potential than drugs like Valium and Ativan but less dangerous than other opioids like OxyContin, Fentanyl, and especially heroin.

As a Schedule III drug, it is considered illegal to abuse Suboxone in any way. Consequently, the United States government has provided maximum sentencing guidelines for crimes involving Suboxone. 

It’s worth remembering, however, that individual states also typically have their own sentencing standards that may or may not adhere to these federal ones. 

The maximum punishments for offenses related to Suboxone as provided by the Congressional Research Service are as follows:

  • Simple Possession
    • 1st Offense – Not less than $1,000 and up to 1 year in prison
    • 2nd Offense – Not less than $2,500 and up to 15 days to 2 years in prison
    • 3rd Offense – Not less than $5,000 and up to 90 days to 3 years in prison
  • Trafficking
    • 1st Offense – A fine of $500,000 ($2.5 million for an organization) and up to 15 years in prison
    • 2nd Offense – A fine of $1 million ($5 million for an organization) and up to 30 years in prison
    • 3rd Offense – A fine of $500,000 ($2.5 million for an organization) and up to life in prison
  • Smuggling
    • Any Offense – A fine of up to $250,000 and up to 20 years in prison 

There are also several mandatory minimum federal penalties that may relate to Suboxone-related crimes as well. According to another document from the Congressional Research Service, these penalties include: 

  • A minimum of 15 days and a maximum of 2 years imprisonment for simple possession of a controlled substance (like Suboxone w/out a prescription) with 1 prior conviction.
  • A minimum of 90 days and a maximum of 3 years imprisonment for simple possession of a controlled substance (like Suboxone w/out a prescription) with 2 prior convictions. 
  • The penalties for distribution of a controlled substance (like Suboxone w/out a prescription): 
    • Distributing to a pregnant woman, or using a child – 1 year minimum with a maximum of 2x the normal penalty
      • For a repeat offender – 3 years minimum with a maximum of 3x usual penalty 
    • Distributing proximate to a school or other prohibited location – 1 year minimum with a maximum of 2x the normal penalty 
      • For a repeat offender - 3 years minimum with a maximum of 3x usual penalty

Suboxone Withdrawal & Detox

Now that you’ve determined that you do in fact have a Suboxone abuse problem, the next step on your road to recovery is getting help. And that means going through detoxification.

You’ve probably heard a lot about this phase of recovery – that it can be incredibly tough to come out in one piece, that this is when most people end up relapsing, and that it’s impossible to persevere without switching to another opioid.

And while it’s true that detoxing from opioids like Suboxone can be an especially trying process, it really is possible to get through it in one piece. Here’s how.

A Quick Look at the What, Why, & How of Detoxification

In order to really get the most out of your Suboxone detoxification (and to make as comfortable as possible), it’s important to know exactly what detox is, what’s going on inside your body as it happens, and what the entire process entails.

The more prepared and knowledgeable you are, the better you’ll be able to both cope with the symptoms and predict what’s coming up next.

Suboxone detoxification happens on two levels. First, the Suboxone is naturally pushed out of the system by your bodily processes. Your urine, sweat, and other filtration systems help to remove every last trace of the drug from your circulatory system.

For Suboxone, the amount of the drug in your body is cut in half (half-life) in about 37 hours while it usually takes up to 9 full days before the buprenorphine is fully cleared from your system.

During this time your body will likely go through a number of particularly painful side effects known as withdrawals. These symptoms come about as a direct result of your body’s physical adaptation to the continuous presence of the buprenorphine in Suboxone.

And when that chemical is suddenly removed for the normal pattern of use, the body struggles to adapt back to functioning without it. For opioid addicted-systems, the downregulation of opioid receptors that helped boost your tolerance to Suboxone prevent natural opioids (called endorphin and enkaphalin) from stimulating these receptors to a healthy degree.

Other neurotransmitters like serotonin also play a role but these adaptations are some of the main causes of these uncomfortable symptoms. And in general, the higher your tolerance is (and, as such, the more extensive your addiction), the more severe these withdrawal symptoms tend to be.

There’s a pretty common misconception among the public that detoxification is the only necessary step of an addiction recovery program. People tend to believe that once a drug is completely removed from the system and the body returns to (semi) normal functioning without it, then they’re essentially “cured” of the addiction and can return to life just as it was before.

This type of thinking is not only blatantly wrong, it can actually end up being dangerous.

To explain, detoxification is only the first step in a comprehensive and effective recovery program. While the body may be purged, in a sense, of the addictive chemical, the mind is still stuck favoring drug-seeking behaviors over others.

This is because addiction alters the physical structure and chemistry of the brain on a fundamental level. Someone who is addicted to a substance like Suboxone isn’t driven to use the drug by some voice in their head – they’re physically rewired by addiction to do so.

And while detox can certainly play a substantial role in preparing the body for continued sobriety, it doesn’t tend to do a whole lot about rewiring the brain. Consequently, an addict will likely return to using again unless the favoring of those drug-seeking behaviors is corrected. 

In fact, NIDA points out that “detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug abuse.”

And when you relapse from an opioid addiction, it can ultimately be fatal.  

That’s why finding an expert Suboxone rehabilitation facility is so crucial to your recovery. These programs help rewired the mind and give you the tools, strategies, and guidance you need to stay sober for the long haul.

The opioid epidemic is growing at an unprecedented pace. More people are addicted to opioids than ever, drug overdoses are at an all-time high, and as more and more doctors are prescribing these drugs without regulation, the damage is only set to get worse. 

And as opioid addiction becomes increasingly common, there’s a new trend emerging among addicts looking for a way out – at-home opioid detox

The benefits here are clear. If you can detox from opioids just as effectively at home, then why would you pay someone else to help you through it. 

What’s more, not being able to afford treatment is a substantial barrier to recovery for many people. Of the 798,000 drug addicts acknowledged that they actually had a problem (only 4% of the total), 30.8% responded that the main reason they did not receive treatment was due to financial concerns.

At-home detox, then, probably sounds like a pretty appealing option for many people. However, deciding to handle your Suboxone detox on your own comes with a number health risks and threats to your recovery’s overall effectiveness as well.

Below are the biggest disadvantages of choosing at-home detox rather than a professional detoxification program. And when it comes to your health and safety, you owe it to yourself to consider them.

  • No Access to Helpful Prescriptions – One benefit of partnering with a professional detoxification program is that doing so may open up the door to a number of beneficial prescription drugs that can make getting through your withdrawals substantially easier. While opioid replacement therapies (ORTs) are likely out of the question, you may still be able to take benzodiazepines, prescription GI medications, and more to help ease the pain.
  • No One To Stop You from Relapsing – When it comes to detox, one of your worst enemies can end up being yourself. After all, how often have you said to yourself that it’s finally time for you to quit, only to fall back into using again once the withdrawals kicked in? With a professional detox center, you can rest assured knowing that there will be someone standing by to protect you from relapsing.
  • Zero Guidance, Zero Support – Part of what makes Suboxone detoxification so difficult is simply not knowing if you are doing the right thing. Maybe you’re worried that there’s something wrong and you’re in physical danger or perhaps you just don’t know how long these symptoms are supposed to last. With professional detox, you’ll have a knowledgeable expert by your side to help guide you through the process and even cheer for you along the way.
  • Left Without Expertise – A formal program for detoxifying from Suboxone will also help you take on your substance use disorder strategically. A detox professional can identify specific needs, difficulties, and risks and cater your detox plan to suit them. They can even help point out problems that maybe you didn’t even recognize (co-occurring mental disorders, traumatic history, overlapping addictions, etc.). All this can be used to create a comprehensive treatment plan that ensures the most successful outcome.

Though Suboxone’s withdrawal process is significantly more manageable than that of methadone’s, it is actually quite similar in the type of symptoms you’ll likely experience throughout the process.

That being said, detoxification isn’t going to be the same for everyone. One person may find themselves back to their old self after only a week of some pretty intense withdrawal symptoms. Another may feel the lingering effects for weeks, months, or even years after quitting their Suboxone habit for good.

Similar to how everyone may experience addiction differently, then, withdrawal is also a wholly unique experience for everyone.

Some of the most notable factors that play into how you experience Suboxone withdrawal are:

  • The time span of your Suboxone addiction
  • The severity of your addiction
  • Your individual genetics and physical makeup
  • Your method of withdrawal (cold turkey, tapering, etc.)
  • Your support throughout the process
  • Whether you are using withdrawal medications

And while your detoxification is bound to be unique to your individual situation, one thing that’s quite consistent across the board is the fact that withdrawing from opioids can be excruciating.

Grueling physical symptoms that are not only painful but also incredibly exhausting can ravage the body for hours and days. Gastrointestinal difficulties (nausea, vomiting, diarrhea, etc.) make the experience even more uncomfortable and to top it all off, your psyche is also plagued by anxiety, depression, and insomnia.

Without a doubt, going through opioid withdrawals can make you feel like you’re losing your mind.

And without the proper professional help to guide you through the process, you’re likely to end up relapsing and turning back to Suboxone or, even worse, stronger opioids as well.

That’s why it’s so important to find an expert Suboxone detox facility to make the process as smooth and successful as possible.

It can be hard to say exactly what you’ll experience during your withdrawal but, in general, you can expect to go through a number of the symptoms (provided by Mental Health Daily) listed below:

  • Anxiety
  • Concentration problems
  • Cravings
  • Depression
  • Discomfort
  • Fatigue
  • Flu-like symptoms
  • Insomnia
  • Malaise
  • Muscle tension
  • Pain
  • Runny nose
  • Sleepiness
  • Restlessness
  • Nausea
  • Mood swings
  • Irritability
  • Headaches
  • Fear of going crazy
  • Dizziness
  • Diarrhea
  • Depersonalization
  • Confusion
  • Body aches

It’s worth noting that the severity of these withdrawals will likely depend on just how addicted to Suboxone you’ve become, along with a number of other individual factors.

The precise length of the withdrawal process is another aspect of detoxification that’s impacted by a number of unique factors. As such, a Suboxone detox timeline isn’t set in stone. 

Having said that, most opioid withdrawals tend to have two different phases: an acute phase and a protracted phase

  • Acute Suboxone Withdrawal Phase – The acute phase, as the name suggests, generally carries with it some of the most intense symptoms. According to MedlinePlus, these include:

    • Agitation
    • Anxiety
    • Muscle aches
    • Increased tearing
    • Insomnia
    • Runny nose
    • Sweating
    • Yawning 

    This phase tends to begin around 24 to 42 hours after your last dose and may persist for several days before the symptoms decrease in severity. 

  • Protracted Suboxone Withdrawal Phase – The protracted phase is marked by a diminished intensity in the symptoms but also brings on a new set of physical maladies including: 

    • Abdominal cramping
    • Diarrhea
    • Dilated pupils
    • Goose bumps
    • Nausea
    • Vomiting

    This stage of withdrawal is likely to last for around a week before the symptoms decrease in severity. As a longer-acting opioid though, these symptoms may not fully disappear for several weeks after the start of the detox process.

The Likelihood of Relapse

Opioids are infamous for having an especially high rate of relapse. The incredibly uncomfortable withdrawals combined with the overpowering cravings work together to make it particularly hard to get through detoxification without turning back to using again.

In fact, some studies have shown that a whopping 91% of opioid dependent users would end up returning to their substance of addiction. Beyond that, an astounding 59% of those users ultimately relapsed within just the first week of detoxification.

However, the rate of relapse depends on a number of factors. Most notably, the intensity of the addiction is typically associated with just how likely a patient is to return to drug use. And the shorter-acting, immediate release, and euphorically potent drugs like heroin tend to be more powerfully addictive than longer-acting and milder ones like Suboxone.

Ultimately though, the odds of relapsing with a Suboxone addiction are actually quite high, just like with other substances of abuse. But with the right professional recovery plan, you can be sure that your odds of maintaining sobriety are much higher than if you had detoxed on your own.

Suboxone Addiction Rehabilitation Treatment

Unfortunately, rehabilitation is sometimes considered to be more of an afterthought when it comes to treating addiction. This is because people put a disproportionate amount of focus on the detoxification process (even though detox alone does little to stymie future substance abuse).

However, rehabilitation can end up being significantly more important when it comes to maintaining sobriety. But what goes into an effective Suboxone rehabilitation program anyway? What kinds of program options are available? Are there important aftercare elements involved as well?

Let’s take a look.

The ultimate aim of rehabilitation is to address problematic behaviors and give individuals the tools and strategies needed to abandon them in favor of healthier life choices. And while it may sound simple to do on the surface, breaking these deep-rooted habits can be an especially difficult process.

That’s because these behaviors have been physically reinforced in the mind over and over again. Think of the brain as an open field and each thought and behavior as a pathway. The more you walk down one pathway, the more defined it becomes. And as that pathway becomes clearer, you’re more likely to walk down it.

The same goes for your thoughts and behaviors. The more often you engage these thought processes and these actions, the more frequently you’ll find yourself using them, sometimes without even realizing it.

Rehabilitation helps you control this inclination towards engaging with harmful thoughts and behaviors. And it does so with the help of counseling, intensive education, and strategic workshops that will give you the tools and strategies you need to actually alter your way of thinking and acting.

Your Suboxone rehab program may use treatments like cognitive-behavioral therapy (CBT), group and solo talk therapy, stress management education, and teachings based on 12-step programs along the way. Generally, every program is a bit different in their techniques.

But what’s important when you’re choosing a drug rehab program is that your program engages in evidence-based treatments, has an adaptive program that caters to your unique needs, and is also fully invested in your successful recovery.

One of the most important takeaways from addiction education is that not every addict is going to have the same needs. In fact, the second principle of effective addiction treatment from NIDA is that “no single treatment is appropriate for everyone.”

As such, not every drug rehab level of care is going to be right for you. That’s why it’s critical that you understand the various pros and cons of the different program types that are available to you.

That way, you’ll be better equipped to recognize and pick out the type of program that meets your specific needs.

  • Inpatient Suboxone Rehabilitation – The most intensive form of rehabilitation available, an inpatient rehab program requires patients to remain on the campus premises at all times. If patients do need to leave, they must be accompanied by a chaperone.

    These programs provide room and board for patients and have a variety of treatments, therapies, and activities that patients must participate in throughout the day. Think of it like a sobriety boot camp. An inpatient program is ideal for individuals who are in recovery from a particularly severe addiction or who have gone through several rehab programs before.

    And while they give patients more time to focus on developing healthy life skills, they often cost more and make it difficult to attend to outside obligations like maintaining a career, going to school, or even raising a family.

  • Outpatient Rehab for Suboxone – An outpatient Suboxone rehabilitation program is going to be a bit looser in terms of program guidelines. Patients in these types of rehab facilities will typically attend a few classes a week (typically several hours in the evening) while being free to live out their lives as normal when not in class.

    As a result, outpatient programs let patients attend to daily needs and obligations and is great for recovering addicts who want to, say, not have to take a month off of work.

    While inpatient programs tend to be pricey, an outpatient rehab program is generally a much more affordable option.

  • Intensive Outpatient Suboxone Rehabilitation – Also known as IOP, an intensive outpatient program combines the comprehensiveness of an inpatient program with the flexibility of an outpatient one. It involves attending several sessions a week (usually more than an outpatient program) that typically last a bit longer than sessions from an outpatient program.

    This allows individuals to still maintain their commitments to life outside of the program without feeling like they’re sacrificing their shot at a complete recovery. It’s a fantastic option for anyone with a hectic life and doesn’t want to compromise their sobriety.

Dual Diagnosis

Just How Important Is Dual Diagnosis for Recovery from Suboxone?

In addition to making sure you’re enrolled in the right kind of program, it’s also important to find a facility that is capable of treating what’s known as dual diagnosis. Dual Diagnosis is the occurrence of both a substance use disorder along with another mental illness such as depression or anxiety.

This condition can be particularly problematic if you’re trying to recover from addiction to a drug like Suboxone because the symptoms of each tend to feed off of each other in a sense. In many cases, an individual will use their substance abuse as a means of coping with the symptoms of their mental illness. As such, the worse their mental illness gets, the more severe their addiction becomes.

Dual diagnosis is incredibly common in the world of addiction – more so than most people may know. According to the 2014 NSDUH, around 21.5 million Americans had a substance use disorder. Of those individuals, 7.9 million (or around 37%) had a co-occurring mental illness.

That’s about a 20% higher rate of occurrence than the general population according to the National Institute of Mental Health.

But despite just how widespread dual diagnosis really is, many facilities aren’t equipped to adequately treat it. Instead, they simply end up treating the substance use disorder alone. And while the individual may recover from their addiction for a while, their looming mental illness (left untreated) soon launches them into relapse and the cycle starts over again.

That’s why it’s so critical that you find a Suboxone rehab facility that knows how to properly treat a dual diagnosis or co-occurring disorder. Not only will these facilities be able to treat both of your conditions and boost your chances of recovery, they’ll also be much better at diagnosing illnesses you may have never known existed.

It’s just one more way to ensure your success in sobriety.

What Is Post-Acute Withdrawal Syndrome?

For a higher standard of treatment, you’ll likely want to go through a private drug rehabilitation program. However, that often means you’ll have to pay a bit more. And insurance can really soften that blow.

While there are two main stages of withdrawal (acute and protracted), there is also a third stage that you may end up experiencing during your Suboxone addiction recovery: post-acute withdrawal syndrome, or PAWS.

PAWS is a condition characterized by extensively protracted symptoms of withdrawal that can end up lasting far longer than the several weeks expected for opioid detoxification. Significantly more research still needs to be done on the subject but, for some, these symptoms can end up lasting for months and even years.

These symptoms vary between psychoactive substances. As such, PAWS for alcohol is not going to be the same as PAWS for cocaine or benzodiazepines. When it comes to opioids, PAWS can present a number of symptoms which, according to SAMHSA, include:

  • Anxiety
  • Depression
  • Sleep disturbances
  • Fatigue
  • Dysphoria
  • Irritability
  • Reduced focus
  • Diminished self-control 

Essentially, PAWS makes it harder to feel like your old self again. And when you’re at the particularly vulnerable stage of recovery when the risk of relapse is highest, these symptoms can make turning back to your Suboxone abuse even more likely.

Partnering with a professional Suboxone rehabilitation facility can be instrumental in helping you get through PAWS. Below are just some of the ways that the experts at these rehab programs can help you persevere through PAWS and increase the likelihood of your full recovery.

  • Can educate you about PAWS and give you realistic attitudes toward recovery
  • Provide motivation throughout to prevent discouragement
  • Evaluation and investigation of symptoms that may be linked to causes other than PAWS like co-occurring disorders or physical trauma
  • Supply you with medication to help manage symptoms
  • Point you to support groups and aftercare options
  • Include behavioral interventions the help promote self-control

12-Step Programs: Narcotics Anonymous for Suboxone Recovery

Built on the same guiding principles used in Alcoholics Anonymous, Narcotics Anonymous is an invaluable resource for anyone struggling with an addiction to Suboxone. This anonymous support group is not only one of the best ways to keep your addiction top of mind and facilitate real change, it can also be instrumental in maintaining your motivation after leaving a rehab program.

According to NIDA, which endorses 12-step programs as evidence-based behavioral therapies for treating addiction, Narcotics Anonymous is built on three key ideas:

  • Acceptance – Realizing that “addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative.”
  • Surrender – “Giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program.”
  • Active Involvement – Maintaining engagement with the 12-step meetings and related activities.

Rather than focusing purely on a single substance like AA, NA instead tackles addiction as a whole. As such, it’s one of the most common misconceptions about the program that NA is strictly for narcotics abusers. In fact, Narcotics Anonymous is quite outspoken about embracing treatment for all addictions, from cocaine and alcohol to Suboxone or even tobacco.

Membership in NA is extensive, and the meetings are widespread and readily available. The organization hosts around 67,000 meetings a week in 139 different countries. And more often than not, there’s usually a meeting happening right in your area.

There are a variety of other 12-step programs available that can also end up being quite beneficial when it comes to facilitating recovery from a Suboxone addiction. These programs, like NA and AA, are built on the 12-step model and, as such, have a number of similarities. However, each focuses on a separate niche.

  • Pills AnonymousAs the name suggests, Pills Anonymous concentrates on addictions related specifically to pill abuse. A dependency on these types of drugs carries with it a unique set of problems involving, for instance, the inherent legality of these medications, the ease of abuse, and more. Attending a Pills Anonymous meeting, then, can help you cope with and heal from the numerous problems that are specific to this kind of addiction. 

    You can find a Pills Anonymous meeting using the organization’s meeting search page

  • Dual Recovery AnonymousA 12-step group set up specifically for addicted individuals who are struggling with a co-occurring disorder such as depression or anxiety, Dual Recovery Anonymous focuses on relapse prevention and finding ways to overcome the problems unique to this common condition. What’s more, the strong social support network can help treat these co-occurring disorders and keep their symptoms at bay. 

    You can find a meeting near you using their meeting locator

  • Nar-AnonThe NA version of Al-Anon, Nar-Anon is catered specifically to the family members and friends of individuals who are struggling with a general addiction, not just to narcotics. These meetings not only provide support and guidance from other people going through a similar issue, they also can give you the strength you need to do something about your loved one’s addiction. 

    Nar-Anon is quite popular and you can find a meeting near you through their meeting database which is updated daily.

Evergreen Addiction Rehab

Northpoint Evergreen Bellevue: Your #1 Source for Suboxone Abuse & Addiction Info

An addiction to Suboxone can be especially tough to recover from. You probably started taking Suboxone as a means of recovering from another opioid, only to find out that you actually developed an addiction to this supposed cure. And that can certainly be disheartening.

But when you fully realize just how damaging an addiction to this medication can be, both to your health and your life in general, you’ll realize that your only option is to get clean for good.

At Northpoint Evergreen Bellevue, we’re here to help you every step of the way. Our expert staff is equipped to provide you with the information you need to start your journey towards sobriety today. Whether it’s a detailed explanation of what’s involved in rehabilitation or even just a simple question on the nature of addiction itself, we can get you the answers you need.

And if you’re ready for Suboxone rehab, there’s no better facility to partner with than Northpoint Evergreen Bellevue.

So, reach out to us and let’s start your recovery, today.

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