The term “Suboxone detox” may sound like an oxymoron to some people. After all, the drug is intended to help heroin and prescription opioid addicts to kick their initial addiction. However, more and more individuals are finding that the drug doesn’t actually fix their problem—it only burdens them with a new addiction to deal with.
Many treatment centers currently rely on a process called “medical detox” as a way to help their patients overcome drug habits. In a medical detox program, patients are given prescription narcotics that enable them to cope with withdrawal symptoms and fight off cravings. These drugs are supposed to help addicts by making their transition into sobriety a bit smoother.
Unfortunately, many of these drugs carry their own risks. Oftentimes, the patient isn’t aware of how dangerous and addictive the drug is when they begin taking it.
Are you addicted to ORT medications? Read on to learn more about what you can do to kick your habit.
If you’ve ever battled with drug addiction, you know that one of the biggest challenges is fighting off those cravings. For many of us, they just don’t seem to end. Once we become chemically dependent on a drug, our brain feels like it needs that drug to survive. It generates cravings to remind us to take the drug because, by using the drug repeatedly, we’ve trained it to believe that we’re going to die without it in our system.
Of course, these cravings get more and more intense as we attempt to wean off of the drug. Cravings make it very difficult for someone to get clean and stay that way.
In an effort to make the recovery process a little easier, scientists and addiction experts developed a process called “opioid replacement therapy”, or ORT. Opioid replacement drugs like Suboxone were developed as a way to feed the addict’s cravings without getting them high. Ideally, this is supposed to help the addict focus on getting clean. Patients are expected to only use the drug for a few weeks before gradually tapering off of it.
For those of you who aren’t familiar, it’s a brand-name product that contains a chemical called buprenorphine. It comes in a few different forms, namely pills or strips that are taken orally. Some users have compared the taste to orange drink (not OJ necessarily, but that bright orange powder that you’d mix with water when you were a kid).
Buprenorphine is classified as an “opioid agonist” chemical, which essentially means that it affects the brain in the same way that heroin, morphine, and oxycodone do. These drugs all provide us with a huge rush of dopamine (the brain chemical that causes us to feel happy) which is why you feel euphoric when you take them.
The difference between buprenorphine and a drug like heroin is that the former is only a “partial agonist”. This just means that it’s not as strong as a full agonist like heroin or oxycodone. If a user takes their prescribed dose of buprenorphine, they’re not going to get the same sized rush that a hit of dope would give them
But, what’s to stop someone from simply taking more buprenorphine in order to get high, right? That’s where many people start running into problems…
No. The former was actually developed as an alternative to the latter. Methadone is technically a ‘full agonist’, which means that it’s much more similar to heroin or other prescription opioids.
Essentially, methadone treatment was a program founded with a belief that addicts would abstain from using heroin while on it. The drug is only administered in single doses (one per day) in authorized clinics to patients suffering from severe addictions. Its administrators believe that, by giving addicts a daily hit, they will return to the clinic each day and therefore hold themselves accountable for avoiding other opioids in the meantime. The drug was intended to be used for, at the very longest, a few months.
Of course, it doesn’t work this way for most people. Many addicts find themselves returning to the methadone clinic every day for years. Unfortunately, some of them also use heroin simultaneously.
There is one key difference between the two drugs. Suboxone actually contains a chemical called naloxone, which is an opioid antagonist.
An opioid antagonist is a drug that blocks opioids from entering the brain. Instead of mimicking the effects of heroin, then, it actually prevents us from feeling its effects. So, when we take a drug with naloxone in it, our opioid cravings are fed. However, if you were to take heroin with naloxone, you wouldn’t be able to get high.
In fact (as some of you may know, unfortunately) taking heroin with naloxone in your system can make you extremely sick. It’s not a pleasant experience.
Essentially, Suboxone was created with the idea in mind that blocking the effects of heroin would enable addicts to focus on the recovery process.
After all, who wants to get high if they can’t feel its effects?
In some sense, this question is valid. Blocking the effects of heroin and prescription opioids eliminates the incentive to get high. As we know, though, addicts often think irrationally. So, taking an opioid antagonist does not always prevent people from trying to get high.
But more on that later…
A big misconception about opioid addicts is that they’re shady characters who live on the street, hang out in alleyways and have no friends or family to speak of. This simply isn’t the case.
A large majority of people currently struggling with opioid addiction are regular old folks—they’re working class people and professionals who just happened to develop a bad habit. Everyday life, as we all know, can get pretty hectic and opioids are one thing that helps some people to manage their stress.
Most often, the people who become addicted to opioid replacement therapy drugs are addicts who’ve gone through detox and are using meds to fight off cravings.
However, there is also a large group of people who’ve never used heroin or even prescription painkillers but still end up addicted to Suboxone or another ORT drug. These folks are working professionals who enjoy the relaxing qualities of opioids but refuse to take heroin or prescription narcotics due to the stigmas of addiction. Because ORT meds are marketed as anti-addiction supplements, it’s easy to fall into the trap of believing that these drugs don’t carry risks. Usually, individuals like this obtain the drugs through illegal means because they don’t want their doctor or family to know that they are taking the drug.
The problem with ORT meds (and opioids, in general) is that we build a tolerance for them over time. If a former addict finds that taking a Suboxone strip with their coffee every morning helps them to fight off their cravings and stay balanced during the day, they can only do this for so long before the drug’s effects diminish. After a while, they’ll need to increase their dose in order to keep feeling its effects.
It’s a familiar feeling for those of us who have already lived through one addiction—using more and more of a drug over time, gradually increasing our dosage, wishing that we could just feel as good as we did the first time we used it.
Yes, it is possible to take too much. However, this is somewhat rare compared to the bigger and more prevalent problem of mixing it with heroin.
Some addicts, of course, make the decision to relapse while under the influence of their ORT medication. This is quite dangerous because the addict won’t be able to feel the effects of the heroin. In the effort to get high, they might take more than their body is capable of handling. Taking too much heroin after you’ve ingested naloxone won’t get you high. It can, however, lead to an overdose.
The interaction between these two drugs isn’t a friendly one, either. When you have naloxone in your system, your brain essentially pushes away any opioids that come near it.
So, if you take a dose of naloxone after you’ve already taken heroin or another opioid, the naloxone will basically push all of the opioids out very quickly. This will result in the onset of precipitated withdrawal, which is a fancy term for when you enter withdrawals immediately.
As you can imagine, that’s not a very fun process to go through. Imagine having the most severe cravings, the most painful stomach cramps and the worst anxiety attack you’ve ever had all at once. That’s a bit what precipitated withdrawal is like.
Disorientation? Confusion? Addiction? Risk of an overdose? Isn’t that why you quit using opiates in the first place?
Opioid replacement therapy and medically-assisted treatment are helpful for many people. A lot of folks find that drugs like buprenorphine enable them to fight off cravings during the initial stages of recovery. However, for many people, buprenorphine is just a crutch that enables them to keep getting high.
If you feel that your ORT drugs are becoming a problem in your life and preventing you from getting sober, it could be time to detox.
When you go through Suboxone detox, you allow your body to get rid of the toxins that built up in your system while you were on it. These toxins are residual effects of the drug and they can linger there for quite some time. In order to get clean, you’ve got to get rid of that stuff. Essentially, when you stop using it, your body will begin to flush it out pretty quickly.
If you’ve been through detox before, you know that it’s not the most pleasant experience. You’ll probably feel some uncomfortable withdrawal symptoms. While these symptoms can get painful, they’re a sign that your body is adjusting to not having the substance in it. Once the withdrawal symptoms end, you’ll be on the road to living a truly opioid-free life.
The severity of these symptoms will depend on the individual and the nature of their habit.
Common symptoms include:
In some cases, these symptoms are severe enough to be characterized as medical emergencies. Addicts in detox may experience seizures, hallucinations, heart palpitations or even heart attacks. It’s important, therefore, that addicts detox under the supervision of a medical professional.
You don’t want to go through detox on your own. Trust us. Withdrawal symptoms can range from inconvenient to dangerous. If things do get dangerous, you’ll want to have a doctor there to make sure that you’re safe as you go through withdrawals.
Doctors can actually take precautions to limit the severity of your symptoms, as well. They’ll interview you prior to beginning the process and do what they can to make sure that you are in as little pain as possible while you withdraw. They’ll make sure that you stay hydrated (which people who detox on their own often forget to do) and provide you with vitamins that ensure you don’t lose too many nutrients along the way.
Lastly, professional detox facilities give you the opportunity to eliminate all triggers and opportunities to relapse. If you’re trying to detox on your couch at home, after all, what’s going to stop you from picking up a Suboxone strip in order to end your withdrawal symptoms? When you check into a facility, that temptation will no longer be there. You can go through withdrawals in peace and then start focusing on rehab as soon as you’re finished.
It’s tough to say exactly how long Suboxone detox takes because it’s different for everybody. Generally, it takes roughly a week for withdrawal symptoms to pass.
First 48 hours: Buprenorphine has a half-life of roughly 36 hours. This means that it takes up to a day and a half for the user’s body to process 50% of the total amount in their system. After you take your last dose, therefore, it’s going to take a least a day before you feel any effects other than just cravings.
Days 2-4: Once the withdrawal symptoms appear, they’ll become severe pretty quickly. It’s like that you’ll vomit and may experience diarrhea. This is due to the fact that your body is working to flush all of the chemicals out of your system. You may become increasingly anxious as you fight off the cravings. It’s going to be uncomfortable, but don’t worry too much. Remind yourself that you’re making the right choice.
Days 4-7: Symptoms will peak around Day 3, so everything after that will be slightly less painful. Cravings will still be severe and it may be difficult to sleep. It’s important that you stay hydrated and try to eat something during this time. If you’ve made it this far, you’ve lost some important nutrients to withdrawals and need to restore them. Vitamins and minerals are necessary for your body to repair itself.
Days 7+: In the majority of cases, physical withdrawal symptoms will cease by the end of the first week. However, those pesky cravings will probably persist. It’s a bummer, but those won’t go away for at least a few months. You need to get into a good rehab program right away and learn how to manage those cravings if you want to stay of Suboxone in the long term.
Here’s the thing: if you’re a former opioid addict and you’re currently abusing buprenorphine, it means that you haven’t exactly overcome your opioid addiction. By taking more and more buprenorphine, you’re really just continuing to feed your opioid cravings. You’re on a slippery slope toward relapsing on heroin or prescription opiates. If you truly want to kick your habit, you may need to seek more treatment.
It may seem crazy to go back to rehab for Suboxone. After all, if you’re currently taking it, you may have already been there once before. However, you may need to try out a non-medicated treatment regimen or look into other treatment drugs.
If you’ve never gone to rehab before, we highly recommend that you give it a try. Here’s what you can expect from an average rehabilitation program:
Education: Understanding how addiction works is an important step in fighting it. In a professional treatment program, you’ll meet with addiction specialists who will help you to comprehend how your drug of choice affects your brain.
Therapy: For most drug addicts, bad habits are rooted in genetics, stress or psychological trauma. You’ll spend the majority of your time in rehab meeting with therapists who will help you to understand why you’re predisposed to addictive behavior. They’ll also work with you to develop methods of coping with stressors in a way that does not involve opioids.
Group support: There are plenty of people who struggle with drug abuse problems just like you. Rehab programs are a great place for you to meet with other folks who’ve been through similar experiences and to offer support and you all work to get clean together.
Family counseling: This one doesn’t apply to everyone but it is very useful for some people. After all, drug addiction tends to have effects on people other than just the addict themselves. If your addiction has impacted the lives of your loved ones, it may be helpful for you to participate in a few family therapy sessions. These meetings, facilitated by a family drug counselor, will give you and your family the opportunity to clear the air so that you can rebuild a stronger relationship.
Many addicts are skeptical about rehab. You may think that it’s a waste of time or money. You may also be under the impression that rehab simply won’t work for you, especially if you’ve already been there for opioid addiction.
We understand your concerns. However, we believe that undergoing professional rehab treatment is the best way to overcome an addiction. Here are a few benefits to professional treatment that self-rehabilitation simply doesn’t offer:
Expert care: In a rehab program, you’ll have access to treatment from highly-trained doctors and therapists. These individuals will assess your addiction on an individual basis and develop a treatment program that meets your needs. Outside of a formal rehabilitation program, you’ll have a tough time finding care this intensive.
A new environment: It’s important to have time and space to focus on recovery during your earliest days of sobriety. The last thing any recovering addict wants it is to bump into their drug dealer at the grocery store only a few days after detox. Many of us simply don’t have the fortitude to fight off the temptation to relapse. A rehab program will provide you with a safe, drug-free space where you can build up the psychological strength needed to avoid relapsing once you leave.
A network of support: Support is so crucial to the recovery process. Unfortunately, many of us lack a peer group that can give us the emotional help we need to stay clean. Organizations like Narcotics Anonymous are fantastic (and we highly recommend that you find an NA meeting) but rehab will enable you to get to know other addicts on a more intimate level. You’ll leave the program knowing that you have a group of people who care about you and want you to stay sober.
A holistic treatment package: Many treatment centers offer both detox and rehabilitation services. This makes the detox-to-rehab transition as smooth as possible. If you attend detox for Suboxone, for example, you’ll have the option to go directly into rehab afterward. This uninterrupted process allows you to focus on recovering without having to get sidetracked along the way.
Medically-assisted treatment doesn’t work for everyone. Obviously, ORT medications have their risks and downsides. Hopefully, there will be a drug that cures addiction available at some point in the near future.
In the meantime, however, we only have a few options. One option is complete abstinence. Addicts who are unable to take ORT drugs without abusing them may need to abstain from using anything that they could lead them toward an addiction. This is a difficult but entirely viable method of getting sober.
Another option is to try a less-addictive rehab drug. Vivitrol, for example, is one product that addicts find to be helpful in the treatment process.
Vivitrol is the brand name of a drug called naltrexone. Unlike the ORT drugs discussed above, naltrexone is a full opioid antagonist. This means that it does not mimic the effects of other opioids in any way, but blocks them from entering the user’s brain. Because of this, it is considered to be entirely non-addictive.
The drug is administered via injection only once per month. For at least 28 days after receiving the shot, an addict will not be able to feel the effects of heroin or other opioids.
Vivitrol’s success, of course, depends on the addict’s commitment to recovery. During the 28-day period that each injection lasts, the addict is responsible for abstaining from drugs and alcohol entirely. Choosing to take drugs while naltrexone is in your system can have some very negative side-effects.
This drug differs from ORT meds in the sense that it can not be administered until the addict has withdrawn entirely. If you’re going through the Suboxone detox process, therefore, you’ll have to wait until your withdrawal symptoms end before you’re able to take naltrexone. Although the waiting period may be difficult, this drug can help you to avoid relapsing while you adjust to living a drug-free life.
We understand that you may have already been through detox once and that you never planned on returning. However, if you’re currently struggling with an addiction to your ORT prescription, it’s important to seek out additional help.
At Northpoint Washington, we’ve treated hundreds of patients for this very same addiction. We’ve been happy to watch them overcome their habit and return to living an opioid-free life. If you’d like to discuss detox, rehab or other treatment options, we’d love to talk.