Read on for factual answers to some of the most common questions about Suboxone and Suboxone treatment.

What Is Suboxone?

Suboxone is a medication that contains two active ingredients: buprenorphine and naloxone.

Buprenorphine

Buprenorphine is a strong analgesic and works in the brain as a partial opiate agonist. The buprenorphine in Suboxone replaces the opiate you've been abusing, filling opiate receptors in the brain and keeping you from experiencing withdrawal symptoms.

Naloxone

Naloxone is an opiate antagonist. Suboxone contains a small amount of naloxone. Naloxone works in the brain by binding to opiate receptors but not activating them. If an opiate-dependent person takes naloxone, he will go into immediate and full withdrawal.

So why put naloxone in Suboxone? If you take Suboxone as directed, sublingually (under the tongue), the small quantity of naloxone in the drug stays inactive. However, if you crush and inject Suboxone tablets while attempting to abuse the medication, the naloxone becomes active in the brain and causes, in an opiate-dependent person, immediate feelings of withdrawal. Naloxone is included in the formulation to keep people from injecting and abusing the medication.

Suboxone

Suboxone has a ceiling of effect. As you take greater doses of the medication the effects increase, until you reach the dosage ceiling at about 32 mgs. After this point, increasing the dosage has little effect. The incorporation of naloxone in Suboxone reduces the abuse potential of the medication, and this ceiling effect further reduces the likelihood of abuse.

Suboxone is classified as a Schedule 2 medication, compared to methadone which is a Schedule 3 medication. Significantly, this lower abuse-risk classification means that doctors may prescribe the medication to you on a take-home basis.

Suboxone Treatment

Suboxone treatment is a form of opiate replacement therapy. Suboxone replaces the opiate you normally abuse, keeping you from feeling physical withdrawal symptoms and also keeping you from feeling intoxicated.

Suboxone treatment allows you to normalize your life, free from compulsions to abuse opiates and free from intoxication.

There are two forms of Suboxone treatment:

Suboxone Detoxification

Suboxone Maintenance Therapy

In Suboxone detoxification treatment, opiate addicts switch over to Suboxone and then, over a period of time, taper their dose of Suboxone down to nothing. The duration of a Suboxone detox can range from three days to a year or more. In general, longer periods of detoxification are more effective and humane.

In Suboxone maintenance therapy, opiate addicts switch to Suboxone as a long-term replacement medication. People on Suboxone maintenance therapy live quite normally and healthily, free from withdrawal symptoms or cravings to abuse opiates. The duration of Suboxone maintenance therapy can range from open-ended to indefinite.

How Is Suboxone Different from Methadone?

Both methadone and Suboxone work to replace illicit or abused opiates and both drugs prevent withdrawal symptoms while keeping you free from intoxication.

Some of the differences between the two medications include:

• Suboxone is a partial opiate agonist while methadone is a full opiate agonist. A partial opiate agonist has a ceiling of effect, meaning that even when taken in large doses, its effects are limited. A full opiate agonist has no such ceiling of effect. Suboxone can be taken home as it is much harder to abuse, but since methadone can be abused, methadone patients need to travel to a clinic each day to take their medication.

• Although Suboxone patients will develop a physical addiction to the medication, Suboxone is not considered as addictive as methadone and the withdrawal symptoms of a Suboxone detox are considered to be less severe than methadone detox withdrawal symptoms.

• The risk of a fatal overdose on the partial agonist Suboxone is much less than with methadone.

• Methadone works very well for people with heavy opiate habits. Partial agonist Suboxone cannot provide effective relief from withdrawal symptoms to people with serious physical addictions.

Who Is Eligible for Suboxone Treatment?

Anyone with a physical addiction to opiates is potentially eligible for treatment with Suboxone. Suboxone will not work for people addicted to non-opiate drugs, such as alcohol or cocaine.

People who may not be suitable candidates for Suboxone include:

• People who sometimes abuse, but who are not addicted to opiates.
• People who abuse alcohol or sedatives such as benzodiazepines (taking Suboxone with CNS depressants can be dangerous).
• People who aren't able or willing to follow a treatment plan are not ideal candidates for take-home medication treatment.
• People with very serious addictions to opiates may not find that Suboxone, even at high doses, offers enough relief from withdrawal symptoms.

Is Suboxone Right for You?

If you are physically addicted to opiates, you may want to choose either methadone or Suboxone to help you get back to your normal life. There are pros and cons to both medications, but since doctors will prescribe Suboxone in month-long doses, most people prefer the greater convenience of Suboxone treatment to the daily commitments of methadone maintenance therapy.

Some reasons why you might choose methadone include:

• Methadone costs less than Suboxone (although both medications cost less than abusing opiates).
• There is no doctor in your area capable of prescribing Suboxone. Methadone remains more widely available.
• Suboxone isn’t strong enough to take away your withdrawal symptoms. Many people who want to take Suboxone find that they need to start off on methadone and taper their dosage down before they are able to find relief from withdrawal using only Suboxone.

Although Suboxone is probably more popular than methadone with new patients, neither drug is "better" than the other. Some people find that Suboxone provides them with effective relief from withdrawal symptoms while minimally disrupting their lifestyle, while others find that they need more relief than Suboxone can provide. Some people find that traveling to a methadone clinic for a daily dose provides needed structure to the day and that the everyday interaction with counselors at a clinic also helps them maintain abstinence. There simply is no one-size-fits-all answer.

Where Can You Find Suboxone Treatment?

Doctors need a special license to prescribe Suboxone and doctors with this license may only prescribe the medication to a limited number of patients. Although some addiction treatment clinics have a special federal certification allowing them to prescribe to an unlimited number of patients, Suboxone remains less widely available than methadone.

To find a Suboxone clinic or doctor in your area, talk to your doctor or call the National Resource Center at (877) 248-3026.