Suboxone addiction develops when individuals misuse or overuse Suboxone, a medication prescribed for treating opioid use disorder. This drug combines two active components: buprenorphine and naloxone.
The signs and symptoms of Suboxone addiction include intense drug cravings, loss of control, compulsive use, shallow breathing, constricted pupils, continued use despite negative health effects, doctor shopping, social isolation, drug-seeking behaviors, and withdrawal symptoms when the medication is stopped.
Side effects of Suboxone addiction can involve dizziness, cough, fever, skin reactions like redness or swelling, urinary difficulties, excessive sweating, trouble sleeping, and chronic headaches. Other common issues include constipation, blurred vision, nausea, vomiting, and potential long-term liver damage.
Withdrawal from Suboxone presents symptoms such as irritability, nausea, vomiting, diarrhea, muscle pain, dilated pupils, depression, and anxiety. Individuals may also suffer from chills, fever, headaches, digestive problems, insomnia, and intense drug cravings.
Treatment options for Suboxone addiction typically include medically supervised detoxification, a gradual reduction in dosage, medication-assisted treatment, behavioral therapy, participation in support groups, and ongoing aftercare to prevent relapse.
Yes, Suboxone can be addictive because it contains buprenorphine, a partial opioid agonist. When misused or taken without proper medical guidance, buprenorphine can lead to dependence and addiction.
Buprenorphine’s potential for abuse arises from its action on opioid receptors, though its abuse potential is lower than that of full opioid agonists. Despite its reduced abuse potential, buprenorphine can still lead to physical dependence. When used improperly or over-extended periods, the body may become accustomed to the drug, and sudden cessation or a significant reduction in dosage can trigger withdrawal symptoms, such as irritability, nausea, muscle aches, and cravings, similar to withdrawal from other opioids.
This is why caution is emphasized in the Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction (2004) by the Center for Substance Abuse Treatment, published by the Substance Abuse and Mental Health Services Administration (SAMHSA). The guidelines stress that healthcare providers must closely monitor patients using Suboxone, particularly in combination with naloxone, to guard against medication diversion. Providers should also be cautious of potential interactions with benzodiazepines, opioid antagonists, and other sedatives.
Suboxone has a moderate potential for addiction if misused or taken outside the prescribed guidelines. In 2022, the Drug Enforcement Administration (DEA) classified Suboxone as a Schedule III controlled substance, indicating it carries a moderate to low risk of physical or psychological dependence, as outlined in the DEA Diversion Control Division Drug & Chemical Evaluation Section “BUPRENORPHINE (Trade Names: Buprenex®, Suboxone®, Subutex®, Zubsolv®, Sublocade®, Butrans®),” published in May 2022.
The combination of buprenorphine with naloxone was specifically designed to lower the potential for abuse, particularly through injection. However, as the 2004 “Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction” by the Center for Substance Abuse Treatment (SAMHSA) highlights, Suboxone is not entirely free from addictive properties.
Suboxone has addictive potential because it contains buprenorphine, a partial opioid agonist. This means it activates the same brain receptors as opioids, though to a lesser extent.
When misused, buprenorphine can lead to moderate physical dependence or strong psychological dependence, as noted in the Drugs.com article on “Buprenorphine,” updated in August 2023. This risk is especially high in individuals with a history of substance abuse, where misuse can result in addiction, overdose, or even death, as the article emphasizes.
A 2020 study by Blazes CK. and Morrow JD., “Reconsidering the Usefulness of Adding Naloxone to Buprenorphine,” highlights the addition of naloxone to buprenorphine to lower the risk of diversion and improper use.
However, the effectiveness of naloxone in preventing Suboxone diversion has been debated, as discussed in the 2022 Frontiers in Psychiatry article, "Suboxone: History, controversy, and open questions." The FDA label for Suboxone indicates that naloxone has a half-life of 2 to 12 hours, while buprenorphine’s half-life ranges from 24 to 42 hours.
This discrepancy suggests that naloxone’s antagonist effects may wear off before buprenorphine’s agonistic effects, potentially allowing individuals to experience the pleasurable effects of buprenorphine. Over time, this repeated exposure can lead to sensitization, reinforcing subconscious drug-seeking behavior.
Suboxone addiction is relatively rare, with approximately 690,000 individuals, about 0.2% of the U.S. population aged 12 and older, reporting misuse of buprenorphine products, including Suboxone, within the past year. This data comes from the Substance Abuse and Mental Health Services Administration (SAMHSA) 2021 report, “Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health.”
Additionally, the Centers for Disease Control and Prevention's “Medications for Opioid Use Disorder Study (MOUD Study),” last revised in January 2022, states that approximately 2.1 million people in the U.S. suffer from opioid use disorder (OUD) linked to prescription opioids, which may include buprenorphine.
These statistics, along with the recognition of Suboxone's addictive potential, highlight the ongoing challenge of addressing and preventing the misuse and potential addiction of this medication.
Another term for Suboxone addiction is buprenorphine addiction. Since buprenorphine is the active ingredient in Suboxone, dependence or misuse of this medication is commonly referred to as buprenorphine addiction.
Many individuals using buprenorphine mistakenly believe it is a milder opioid and therefore less likely to cause addiction compared to stronger opioids like methadone. However, regardless of its potency, all controlled substances, including buprenorphine, have the potential for abuse, dependence, and addiction, as noted in the “Drugs of Abuse: A DEA Resource Guide,” published by the Drug Enforcement Administration in 2020.
Suboxone addiction is characterized by a combination of physical, behavioral, and psychological symptoms, which vary in intensity. Below are the common signs of Suboxone addiction:
These signs collectively point to the presence of Suboxone addiction and underline the need for professional intervention to manage and treat the condition effectively.
The causes of Suboxone addiction are multifaceted, involving a combination of physiological, psychological, and environmental factors.
Here are the key potential causes of Suboxone addiction:
Each of these factors can interact to create a perfect storm that increases the risk of Suboxone addiction, highlighting the importance of proper use, medical supervision, and addressing underlying mental health and environmental influences.
The time it takes to develop an addiction to Suboxone can vary based on factors such as individual susceptibility, dosage, frequency of use, and whether the medication is taken as prescribed. For most people using Suboxone properly under medical supervision for opioid use disorder (OUD), the risk of addiction is minimized.
However, when Suboxone is misused, by taking higher doses, using it more frequently than prescribed, or using it without medical supervision, addiction can develop within a few weeks to a few months. Individuals who misuse Suboxone may start to experience dependence and addiction symptoms in as little as 7 to 30 days of improper use.
Buprenorphine, the active ingredient in Suboxone, acts on opioid receptors in the brain. With repeated misuse, tolerance can develop quickly, requiring higher doses for the same effect, which can lead to physical dependence and psychological addiction. As misuse continues, signs of addiction, such as drug cravings, loss of control, and compulsive use, may become evident within the first few weeks.
If Suboxone use is stopped or reduced suddenly, withdrawal symptoms, such as irritability, nausea, muscle aches, and cravings, can begin within 12-24 hours and may persist for days or even weeks. These withdrawal symptoms are a key indicator of physical dependence and addiction.
The side effects of Suboxone addiction can affect various systems in the body. These effects can be both short-term and long-term, depending on the duration and intensity of misuse. Below is a breakdown of the common side effects:
Short-term side effects:
Long-term side effects:
Overall, these side effects reflect the broad and varying impacts of Suboxone addiction on the body. Short-term side effects primarily affect daily functioning, while long-term misuse can lead to more severe, persistent health problems that require medical intervention. Addressing addiction early and seeking treatment can help prevent or mitigate these risks.
Suboxone addiction during pregnancy poses significant risks to both the mother and the developing fetus. While Suboxone is often prescribed as part of medication-assisted treatment (MAT) for opioid use disorder (OUD) during pregnancy, misuse or addiction to Suboxone can lead to serious complications. Here are the side effects of Suboxone addiction on pregnant women:
While Suboxone can be a crucial part of treating opioid use disorder during pregnancy, it must be used under strict medical supervision. Healthcare providers often recommend using Suboxone at the lowest effective dose to minimize the risk to both the mother and the baby. Additionally, comprehensive prenatal care, including monitoring for signs of complications and providing counseling and support, is essential for ensuring a healthy pregnancy and a safer outcome for the baby.
Yes, Suboxone can indirectly influence personality, leading to variations in how individuals respond emotionally. These changes can include increased sociability or extroversion, as well as instances of heightened withdrawal and introversion. The extent and nature of these changes vary among individuals, depending on how the medication interacts with the brain.
While some people report mood or personality shifts during Suboxone treatment, it’s important to recognize that these changes cannot be attributed solely to the medication. Suboxone is typically prescribed during pivotal moments in a person’s life, especially when they commit to recovery, which can lead to a wide range of emotional experiences. These can include negative mood changes or, conversely, feelings of success and improved emotional well-being associated with abstaining from drug use.
It is crucial to consider that mood changes, such as fatigue, anxiety, or irritability, are often linked to the broader process of quitting drugs and the significant lifestyle changes that accompany recovery. Determining whether these shifts are due to Suboxone or other life factors is difficult, given the complex and multifactorial nature of mood and personality.
The potential indirect effects of buprenorphine on personality were explored in a 2008 study by Sansone RA et al., titled “The Prevalence of Borderline Personality Among Buprenorphine Patients”, published in the International Journal of Psychiatry in Medicine. The study found that borderline personality disorder (BPD) was more prevalent among individuals receiving buprenorphine treatment for opioid addiction.
BPD is a psychiatric disorder that significantly impairs emotional regulation, leading to increased impulsivity, distorted self-image, and challenges in interpersonal relationships. Individuals undergoing Suboxone or buprenorphine treatment may experience altered emotional responses, particularly exaggerated reactions to negative stimuli and reduced responses to positive experiences.
Yes, it is possible to overdose on Suboxone , particularly if taken in excessive amounts or combined with other substances such as alcohol or benzodiazepines.
According to Medsafe’s consumer medicine information on “SUBOXONE® Sublingual Tablets” (last updated in July 2021), while Suboxone is prescribed for managing opioid dependence, it carries a risk of misuse, which can result in overdose and potentially fatal consequences.
The risk of overdose is higher in individuals without a history of opioid use, older adults, or those who combine Suboxone with alcohol, benzodiazepines, or other medications, as noted in the Drugs.com article titled “Can You Overdose on Suboxone?” (last revised in March 2023).
Symptoms of a Suboxone overdose include irregular, fast, slow, or shallow breathing, extreme drowsiness, confusion, unusual tiredness or weakness, and dizziness or faintness when standing up quickly from a sitting or lying position, as detailed in the Drugs.com article “Suboxone Side Effects” (updated in August 2023). Additional overdose symptoms can include blurred vision, pale or blue lips, fingernails, or skin, and pinpoint pupils.
In severe cases, an overdose on Suboxone can lead to seizures, coma, and even death. It is essential to take Suboxone strictly as prescribed by a healthcare provider and to disclose any other medications or substances being used to minimize the risk of overdose.
The symptoms of Suboxone withdrawal include irritability, nausea, vomiting, diarrhea, muscle aches, dilated pupils, depression, and anxiety. These symptoms typically emerge when individuals who are dependent on Suboxone suddenly reduce their dosage or stop using it altogether.
The withdrawal process usually follows a predictable pattern. In the first 72 hours, individuals may experience physical symptoms such as chills, fever, headaches, gastrointestinal issues, and insomnia, as noted in the Drugs.com article “How long does Suboxone withdrawal last?” (last updated in March 2023).
In the following days, muscle aches, persistent insomnia, and mood swings often continue. After about two weeks, symptoms of depression become more prominent, and drug cravings typically begin.
Suboxone withdrawal symptoms usually last around a month, though the duration can vary depending on factors like the length of Suboxone use, dosage levels, co-existing medical conditions, and alcohol consumption.
For individuals considering discontinuation or detoxification from Suboxone, it is crucial to do so under the supervision of a healthcare professional. Gradual tapering, along with the use of specific medications and behavioral therapies, can help manage withdrawal symptoms and improve the chances of a successful recovery.
Treating Suboxone addiction requires a multifaceted approach that addresses both the physical dependence and the underlying psychological factors contributing to the addiction. Below are the key treatment options for Suboxone addiction:
Each of these treatment options works together to help individuals manage their addiction, improve their well-being, and promote long-term recovery. It is important for those undergoing Suboxone addiction treatment to seek professional guidance to ensure the best possible outcome.
Suboxone is primarily used to treat opioid dependence. It is part of a comprehensive medical, social, and mental treatment plan designed to suppress opioid withdrawal symptoms and reduce cravings for opioids, as outlined in Medsafe's consumer medicine information on “SUBOXONE® Sublingual Tablets” (last updated in July 2021).
In 2018, the FDA approved the first generic versions of Suboxone sublingual film, as mentioned in the document “FDA approves first generic versions of Suboxone sublingual film, which may increase access to treatment for opioid dependence.” This approval aimed to increase access to opioid dependence treatment. The document highlighted that individuals undergoing medication-assisted treatment (MAT) for opioid use disorder (OUD) experience a 50% reduction in the risk of death from all causes.
Suboxone is effective in treating opioid use disorder (OUD) because it contains buprenorphine, a partial opioid agonist. Buprenorphine reduces cravings and withdrawal symptoms without inducing intense euphoria. Naloxone, the other component of Suboxone, discourages misuse and blocks the effects of other opioids.
According to the World Health Organization (WHO) in the 2009 “Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence,” buprenorphine’s partial agonist activity means it does not cause opioid tolerance to the same extent as methadone. Additionally, it has a high receptor affinity, allowing it to block opioid effects without causing the same level of tolerance associated with methadone.
The slow dissociation of buprenorphine from receptors contributes to a milder withdrawal syndrome compared to methadone. As noted in the Center for Substance Abuse Treatment’s 2004 “Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction” from the Substance Abuse and Mental Health Services Administration (SAMHSA), one of the key advantages of buprenorphine or its formulation, Suboxone, is its safety. Its partial agonist action creates a “ceiling effect,” which significantly lowers the risk of overdose compared to opioids like methadone.
Medication-assisted treatment (MAT) is a therapeutic approach that combines medications with counseling and behavioral therapies to treat substance use disorders, particularly opioid use disorders. MAT supports individuals in maintaining their recovery and is recognized for its effectiveness in helping people manage addiction, as defined by the United States Food & Drug Administration in the article “Information about Medication-Assisted Treatment (MAT)” (last updated in May 2023).
According to this article, the FDA has approved three medications for opioid dependence treatment: buprenorphine, methadone, and naltrexone, due to their proven safety and effectiveness.
A 2020 randomized study titled “Medication-Assisted Treatment for Opioid Use Disorder in a Rural Family Medicine Practice,” published in the Journal of Primary Care & Community Health, found that individuals diagnosed with opioid use disorder (OUD) who were treated with either methadone or Suboxone showed a 33.2% abstinence rate from heroin and a 20.7% abstinence rate from all opioids over a five-year period. The study also reported that MAT led to a 51% reduction in the use of emergency department services.
MAT is an evidence-based method that supports individuals in their recovery journey. By integrating medication with a personalized treatment plan, MAT helps individuals address their addiction and work toward long-term recovery.
Suboxone and methadone differ significantly in composition, effects, potential for misuse, and treatment protocols.
Suboxone combines buprenorphine, a partial opioid agonist, with naloxone, an opioid antagonist. This combination reduces misuse potential since naloxone counteracts euphoria if injected. Suboxone is taken sublingually, making it harder to misuse. In contrast, methadone, a full opioid agonist, produces stronger effects and is dispensed orally at specialized clinics. Methadone is classified as a Schedule II controlled substance, indicating a higher risk of misuse and addiction compared to Suboxone, which is a Schedule III controlled substance.
Suboxone tends to have milder withdrawal symptoms than methadone, as methadone’s full agonist action can lead to more intense withdrawal, especially at higher doses. Buprenorphine in Suboxone also has a “ceiling effect,” meaning its effects plateau at higher doses, reducing the risk of overdose. Methadone lacks this effect, making it more prone to overdose when misused.
Suboxone offers more flexibility since it can be prescribed and administered in a physician’s office, whereas methadone typically requires daily visits to treatment centers. Additionally, Suboxone has a longer half-life (36-48 hours) compared to methadone (24-36 hours), allowing for less frequent dosing.
Subutex, which contains only buprenorphine and no naloxone, is stronger than Suboxone in terms of opioid effects. Without naloxone, Subutex can be misused more easily and is more addictive. However, Suboxone is generally preferred due to naloxone’s deterrent effect on misuse.
Overall, methadone is more addictive than Suboxone due to its full opioid agonist properties and the lack of a ceiling effect. Suboxone’s combination of buprenorphine and naloxone makes it less likely to be misused and more suitable for long-term treatment.