The synthetic opiate buprenorphine is commonly known by brand names – Suboxone and Subutex. It is an opioid antagonist that has greatly enhanced how we are able to treat individuals who come to our rehab chemically dependent to heroin or other opiates (such as OxyContin or Vicodin).
Suboxone may be administered via injection during opiate
detoxification, and then also orally in sublingual tablets (Subutex)
during the early recovery stage. Suboxone treatments have allowed us to
greatly increase the comfort of the detoxifying individual. The Subutex
tablets help reduce cravings for opiates during the first few months of
An opioid “receptor antagonist” is a drug that binds to a receptor in
your brain that would usually receive a narcotic. The result of taking
an opioid receptor antagonist is a reduced ability for a narcotic to interact
with the receptors in the brain, and thus, less physical response to
Suboxone and Subutex are enhancements to the treatment program at Sober
Living by the Sea, but we strongly feel that a thorough recovery
program should be adhered to for the man or woman to have a good chance
at maintaining long-term sobriety.
Contact our admissions
and intake specialists to begin the assessment process that can lead to
receiving Suboxone detox here in Newport Beach, California.
More about the history of Suboxone (Buprenorphine) Detoxification.
For most of the last century, the ability of doctors and treatment
centers to help opioid addicts has been limited by the federal
government. The Harrison Narcotic Act of 1914, originally designed as a
tax act, was interpreted by the Supreme Court to prohibit the
prescription of opioids to opioid addicts, even in the course of their
treatment. From then on, an entire line of practice – the tapering of
opioid dosage to ease the pain of withdrawal – was against the law.
One exception was methadone.
When used properly, methadone maintenance is an effective treatment for
opioid addiction: it blocks the effects of other opioids like heroin
and greatly improves the patient’s psychosocial stability.
Unfortunately, hostility to the idea of maintaining addicts on a
substitute drug has led to federal restriction of methadone that is so
tight that the drug can only be prescribed by specific clinics. These
clinics vary widely in the quality of care they provide. Additionally,
methadone can cause euphoria, which can increase the probability of
relapse. The combination of these factors has limited methadone’s
effectiveness as a medication not only for maintenance, but for
detoxification as well.
In the latter part of the twentieth
century, the medical management of opioid withdrawal was largely left
to treatment centers, where physicians could prescribe only a handful
of symptomatic medications. Opioid addicts who could not afford medical
treatment are left to detoxify themselves “cold turkey,” which usually
results in a return to opioid drug use.
Now there is hope on the horizon. The Drug Abuse Treatment Act of 2000
allows the prescription of buprenorphine to opioid addicts to ease the
symptoms of withdrawal. Whereas drugs like morphine, heroin and
methadone are opioid receptor agonists – meaning they fully bind opioid
receptors – buprenorphine is a partial opioid receptor agonist. This
gives buprenorphine the ability to relieve the symptoms of opioid
withdrawal without producing the euphoria of the full agonist drugs
like methadone. For the first time, physicians can use buprenorphine to
provide a comfortable detox for opioid addicted patients, thereby
setting the stage for more effective inpatient or outpatient treatment.
Buprenorphine is available in two forms: a sublingually (under the
tongue) administered tablet containing only buprenorphine (Subutex),
and a sublingually administered tablet containing buprenorphine and the
opioid antagonist (blocker) naloxone (Suboxone). Suboxone eliminates
the danger of abuse of the opioid component of the medication:
administered sublingually, only the buprenorphine is absorbed, but if
the patient attempts to inject Suboxone, the opioid antagonist blocks
the effect of the buprenorphine. Subutex and Suboxone are manufactured
Perhaps the most important feature of the Drug Abuse Treatment Act and
the availability of Subutex and Suboxone, is that it gives the ability
of physicians to treat addicts in the privacy of their office. Patients
no longer need to travel to substandard clinics to receive help for
their addiction. As mandated by the DATA, physicians wishing to
prescribe buprenorphine must complete the instructional course on the
protocol for Office-based Opioid Treatment given by the Center for
Substance Abuse Treatment. A listing of certified physicians can be
found at www.buprenorphine.samhsa.gov.
Suboxone has been available for several years and the results have been
staggeringly positive. In the past, many opioid addicts attempting to
achieve sobriety by the old methods (medical detox or “cold turkey”)
failed to complete their detoxification. Now those patients are
completing detox and entering treatment. Patients prescribed Suboxone
are reporting that for the first time they feel some hope.