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Suboxone: A Comprehensive Guide to Treatment and Safety

America’s overdose epidemic has been characterized as 4 distinct and interrelated epidemics: prescription opioids, heroin, fentanyl and fentanyl analogues, and stimulants. Even though physicians have decreased prescribing of opioid analgesics, America’s patients are currently facing a drug overdose – both fatal and non-fatal – epidemic that is fueled by illicit drugs, including counterfeit fentanyl and fentanyl analogues, psychostimulants, heroin, cocaine, and drug combinations.

Suboxone Truth’s

1. Suboxone and Pregnancy: Buprenorphine-naloxone is a commonly used maintenance medication for nonpregnant patients with opioid dependence. It has been demonstrated to be a safe and effective opioid agonist in outpatient and primary care settings. Recent evidence shows buprenorphine to be equivalent or superior to methadone in managing opioid dependence in pregnancy. Studies found that, within the context of an established prenatal program that values opioid tapering to decrease NAS, (neonatal abstinence syndrome) buprenorphine-naloxone can be safely used in pregnancy. Studies also found that pregnancies exposed to buprenorphine-naloxone had significantly larger (normal) birth weights than pregnancies exposed to other narcotics did (P = .004), and more patients taking buprenorphine naloxone were able to cease illicit opioid use in pregnancy.

2. Suboxone and its mechanism of action: Suboxone contains four parts buprenorphine and one part naloxone. Buprenorphine works by tricking the brain
into thinking that it is receiving a full dose of an opioid, while naloxone blocks the activation of opioid receptors, thereby reversing the euphoric effects of buprenorphine. Opioid receptors are found in the brain, and they consist of opioid substances naturally produced in the body. Opioid receptor activation results in feelings of reward and pleasure.

3. Suboxone and the risk of overdose: Suboxone has a lower overdose potential because it produces a “ceiling effect.” This is a pharmacological phenomenon in which the impact of the drug on the body plateaus. This means that once you reach the therapeutic limit of Suboxone, taking more than its intended dosage (24-32 mg) per day will no longer yield a euphoric effect—and only potential side effects.

4. Suboxone and the risk of addiction and overdosing: Despite the life-saving benefits of Suboxone, one thing worth keeping in mind is that it is an opioid in itself, so if it’s taken at too high of a dose, without prescription, or in any other way than intended on the label, it can still put you at risk for addiction and overdose. Given Suboxone ceiling effect, some people resort to injecting the drug, thereby bypassing its time-release qualities and making overdose much more likely.

5. How is Suboxone given: The first is the induction phase, in which you undergo an intake assessment to determine the proper dose. The second step is the stabilization phase, in which you receive counseling and support services to confront the underlying cause of your addiction. The third step is the maintenance phase, in which you continue to take the correct dose of Suboxone while beginning to return to a normal lifestyle. The last step is the taper phase, in which your mental health provider will gradually reduce the required dose of Suboxone until you no longer need it.

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