Suboxone in your system

suboxone in your system

Table of Contents

What is Suboxone?

Suboxone is a medical treatment for addiction that uses a mixture of two drugs: buprenorphine and naloxone. When Suboxone was released in 2002, many hailed it as an exciting new advancement in addiction treatment. Unlike other MAT, Suboxone could be taken home, which allowed many to take it long-term with ease. However, the substance does have a dangerous side. 

What does Suboxone Treat?

Recovery can be challenging. Once the body is accustomed to a drug, it can cause problematic symptoms as it tries to function without the substance. These symptoms can be so uncomfortable that people avoid treatment to prevent withdrawal.

To help ease the body off the presence of drugs, medication-assisted treatment, otherwise known as MAT, can help reduce dependence. MAT medication, such as Suboxone, works as an opioid antagonist, negating the response of opioids such as morphine, oxycodone, and heroin.

The use of MAT reduces the difficulty of withdrawals to make symptoms more manageable than quitting “cold turkey.” It also helps to reduce the feeling of cravings, which can be overwhelming when opioids have initially left the system. In theory, this reduction should make maintaining sobriety easier for those who are overwhelmed with withdrawal symptoms and cravings.

Research shows that MATs like Suboxone lower the risk of experiencing a fatal overdose by about 50%.1

Suboxone vs. Methadone

Methadone has long been used as an MAT treatment. However, methadone has a high risk of dependency as the body grows accustomed to recovery. Addiction treatment specialists began to turn to Suboxone in the early 2000s. 

One of the main reasons that specialists switched to Suboxone is due to its lower risk of developing a dependency. It is not as addictive because the buprenorphine in Suboxone is a partial opioid agonist, whereas methadone is a complete and long-lasting agonist. Suboxone does not have the same effects and is weaker than methadone 

Because of its lower risk of addiction, Suboxone can be taken at home, whereas methadone can only be taken when an individual is under medical supervision at a certified opioid addiction center. 

Additionally, Suboxone offers fewer side effects. The side effects that the drug does have are usually more physical, whereas methadone side effects can be more mental. 

Suboxone vs. Buprenorphine

Suboxone is created by a combination of both buprenorphine and naloxone. Buprenorphine works as an “opioid agonist,” meaning that it has a slightly opioid-like effect on the body. However, it is not as strong as more traditional opioid agonists, such as heroin.

Buprenorphine also has a regulating effect, which means a limited opioid effect no matter how much is consumed. Also called a “ceiling effect,” regulation makes Suboxone difficult to overdose on.

Addiction experts use Suboxone to reduce the chance of developing a dependency. However, Suboxone differs from buprenorphine with its use of naloxone. It works as a blocker to counteract opioids. On its own, naloxone can be used to offset an overdose when used in the form of a nasal spray.

Naloxone will cause withdrawal symptoms if injected directly into the bloodstream instead of taken as prescribed. The purpose of including naloxone in the medication is to discourage injection by those who use intravenous opioids, such as heroin. While, in theory, naloxone should prevent shooting up Suboxone, anecdotal evidence reveals that this may not be the case. Some people do report using naloxone without issues.2

Suboxone binds to the opioid receptors in the brain, blocking other opioids such as heroin and mitigating its effects within the body. Suboxone uses the same receptors as opioids without producing the same high. It also binds more effectively than other opioids so that all other narcotics have less of an effect.

How is Suboxone Metabolized?

There are three ways to take Suboxone, including tablets, buccal film strips, and sublingual film stripsBuccal film strips mean that it is placed between the gums and teeth, while sublingual is taken below the tongue. 

Suboxone Half-Life

Suboxone is taken in four different strengths. It can vary from 2mg buprenorphine and 0.5mg naloxone up to 12 mg buprenorphine and 3mg naloxone. 

These various doses allow a slow Suboxone taper when it is no longer wanted or needed. The dosage can also vary based on the severity of withdrawal and opiate dependency. 

However, this variation in strengths also affects its half-life, or how long it takes for half of the presence of medication to leave the system. Compared to other opioids, Suboxone has a long elimination half-life and is typically about 37 hours. It can take up to eight days for the substance to completely leave the body. 

The long half-life can be concerning because it allows the substance to slowly build up in the body over time when taken daily as directed. 

Factors That Affect Detection Time

Not everyone is affected by Suboxone in the same manner. Some of the factors that might affect how long it takes Suboxone to leave the system include:

  • Body fat content
  • Weight and height
  • Age
  • Metabolism speed
  • Size of the last dose taken
  • Amount of time the abuse has gone on
  • Liver health

Is Suboxone Addictive?

Suboxone is an opioid. As a result, there is always a possibility that it can be abused. Like any medication, there are risks with taking Suboxone, primarily when it is handled differently than prescribed.

While naloxone limits the ability to get an opiate-like high, a tolerance can be developed during long-term use. Ending Suboxone use can also result in withdrawal symptoms. Some of these symptoms include:

  • Nausea and vomiting
  • Irritability
  • Trouble sleeping
  • Muscle aches
  • Constipation

Taking Suboxone other than as prescribed can result in cravings and seeking other addictive substances.

While it does not produce a significant high to a body accustomed to full opioids, those who have never used or sparingly used opioids are more vulnerable to developing an addiction to any buprenorphine formulation.

Statistics on Suboxone Use

As the modern world faces skyrocketing addiction rates, Suboxone use increases with it. In 2002, when the FDA first approved the medication, 20,000 people were prescribed the drug.2

By 2013, Suboxone beat Viagra and Adderall with over $1.5 billion in sales. From 2003-2013, Suboxone was the primary suspect in over 400 deaths around the country.3 Approximately 9.8 million prescriptions were filled in 2012, according to the U.S. Drug Enforcement Administration.4

Is Suboxone Safe?

When taken under medical supervision, Suboxone can be safe. However, overdoses do happen.

Some of the common Suboxone side effects include:

  • Sweating
  • Headaches
  • Insomnia and trouble sleeping
  • Mood issues, such as anxiety and depression
  • Withdrawal symptoms
  • Weakness and exhaustion
  • Back pain
  • Burning tongue
  • Red mouth
 

Some of the more serious effects of Suboxone include:

  • Liver damage
  • Breathing issues
  • Hormone imbalance
  • Allergic reaction
  • Severe withdrawals
  • Coma

It is possible to experience a Suboxone overdose if it is combined with alcohol, benzodiazepines, or opioids. While naloxone reduces the chance of overdosing, overusing these substances can still result in an overdose.

Suboxone Detection Test

The liver creates metabolites even after metabolizing Suboxone, meaning that it can be detected long after eight days. Some of the ways Suboxone is identified in the body include:

  • Urine: Suboxone can show up in urine just 40 minutes after use, but it can be detected up to two weeks later depending on how long and heavily it has been taken.
  • Hair: While it may not be as reliable as other tests, Suboxone can be detected up to three months after use.
  • Blood: It takes about two hours for a dosage to appear in the urine. However, there is a smaller detection window in a urine test.
  • Saliva: The substance can test positive for a few days up to a week after the last dosage of it.

Treatment for Suboxone Addiction

Addiction to Suboxone does not have to be lifelong. With the proper treatment, recovery is possible. 

Detox

If addiction is suspected, a Suboxone taper under the supervision of an addiction professional is more effective than quitting “cold turkey.” Stopping Suboxone use all at once can result in severe withdrawal symptoms.

According to some research, those who use the cold turkey method have only a 25% chance of maintaining sobriety after one year.5

Therapies

Taking MATs on their own is not an answer to addiction. Instead, it only increases the risk of developing a new addiction. Different therapies can help address the underlying issues that accompany addiction, including:

  • Individual therapy
  • Group therapy
  • Family therapy

Therapy provides helpful tools for managing life without addiction. It can provide the necessary support for both those who have an addiction as well as their loved ones.


Resources

  1. https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496
  2. https://www.thefix.com/content/best-kept-secret-addiction-treatment?page=all
  3. https://www.thefix.com/content/best-kept-secret-addiction-treatment?page=all
  4. https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf
  5. https://psychcentral.com/lib/how-is-suboxone-treatment-different-than-drug-abuse#1

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