Morphine, heroin, and fentanyl are a few names synonymous with drug abuse and overdose. These drugs have brought unfathomable anguish to many people and their families over the course of this century.
Impending death with continued usage or suffering through the withdrawal symptoms – this is what life boils down to for all those currently in the claws of opiates. And while 12-step recovery centers and rehabs are doing a lot in order to help the recovering addicts, relapse is a sad but often-seen reality.
Does this mean it is time for Medically Assisted Treatment (MAT)?
Suboxone, a prescription medicine currently being used to treat opioid addiction, is a controversial drug that is catching the fancy of many addicts and addiction specialists.
The controversy in question arises from the chemical composition of the drug which contains buprenorphine and naloxone.
To many, it is like replacing one lethal drug with a milder version of it. And while that, indeed, is the case, Suboxone helps curb opioid dependence as it helps in easing the cravings and reduces post opium use withdrawal symptoms and has a low risk of abuse.
How Does Suboxone Work?
Suboxone has two parts: buprenorphine and naloxone. While the former binds with neuroreceptors to curb the withdrawal symptoms, the latter helps in discouraging misuse by making the user extremely sick if the drug is injected.
The mechanism at work is very similar to that of heroin. When heroin, or fentanyl or that matter, hits the system, the brain is flooded with one of the ‘happy’ hormones called dopamine, creating an intensely pleasurable sensation while reducing any pain.
The breathing slows and the person enters a temporary euphoric state; in colloquial terms, the person is now high.
But, this where Heroin and Buprenorphine differ. The way they bind with opioid receptors is different.
While heroin completely binds with the receptors and produces all the aforementioned effects, the latter is a long-acting binder that only binds partially with the said receptors.
In case of heroin, the euphoria increase with an increase in the dose, but with buprenorphine, the effects reach a plateau level i.e. an increase in the dose will not increase the ‘good feeling’.
In addition to that, for opium users, using SubOxone will not create the sensation of ‘high’, due to the mild euphoric effect in comparison to heroin.
Also, heroin-induced euphoria lasts only for a few hours while buprenorphine stays in the system for nearly 35 hours, which is 10 times longer than oxycodone, a regular opioid. This helps in subsiding the withdrawal symptoms for over a day.
It discourages misuse of Suboxone. While buprenorphine curbs the withdrawal symptoms, naloxone reduces the effect of any opioids in the system. As it is an opioid antagonist, i.e. it blocks opiates from binding with the neuroreceptors,
negating the effects of opiates.
Suboxone: Should You Or Should You Not?
The Bright Side
MAT or Medically Assisted Treatment is the gold standard for addiction care. It was found to cut mortality rates among the users by half or more. While SubOxone will always be censured due to it being an opium-derivative, it is, in truth, changing lives and giving people another chance at life.
The patients are often able to go to school and get employed without the everyday struggles that come with addiction, like coming up with money, meeting the dealers, avoiding the police, and the physical and mental strain.
However, SubOxone is no ‘magic pill’ that erases an addiction. It does not eliminate the chances of a relapse. It is merely another tool in the large box labeled ‘addiction care’ that works with self-care, determination, support communities, and 12-step centers.
It is not a medicine-dependent treatment but rather an assisted one. It is a tool for those having a hard time recovering from the addiction.
While many rehabs and support communities remain resistant to the use of Suboxone, it is a matter of personal choice. To many, a subdued addiction is better than a full-fledged heroin dose and a potential overdose.
The Dark Side
Those trying to recover from addiction for the first time should stick to conventional methods like counseling, talk therapy, 12-step meetings etc., as the ideal goal of addiction care is 100% self-reliance.
Being dependent on a pill would not help in achieving this goal. Also, MAT can be highly dangerous if forced upon a person. A person who does not want to receive MAT and is not ready to fully commit to his/her sobriety is likely to use again.
Side Effects Of Suboxone
The ideal goal of addiction treatment is sobriety through self-reliance. Suboxone is a measure that should be prescribed when all else fails.
However, those who aren’t willing to accept MAT might slip down to an unpromising path. With SubOxone, naloxone blocks the opioid receptors, subduing any euphoria. This makes room for potential overdose, as a person might try to use more to feel the effects.
Also, getting off the drug post-recovery is another battle in itself. The withdrawal symptoms can last over a month and the severity depends on the duration of Suboxone usage and the dose taken.
The reason why 12-step communities, rehabs, and even the society, on the whole, is wary of SubOxone is its opiate roots. They argue that is like replacing a highly addictive drug with a milder, subdued derivative.
However, it is like comparing vaccine and disease. Just as a vaccine works to avoid the disease, Suboxone works to normalize the lives of opiate addicts without suffering through withdrawals and recurring cravings.
If you look at the bigger picture, it gets them to lead a life in which they can concentrate on the responsibilities without feeling the brunt of withdrawals, which would have otherwise taken them years to achieve through conventional means.
This MAT can be beneficial if implemented carefully, hence, dismissing it as a replacement drug is selling it short.