Get clear, helpful answers in our FAQs section.
Q. What are opioids?

A. Opioids are drugs that work in the body the way opium does. Some are made directly from opium (for example, morphine and codeine), while others are man-made but similar chemically to opium (for example, the painkillers oxycodone, hydrocodone, and fentanyl, better known by such brand names as OxyContin®, Vicodin®, Percocet®, and Actiq®*) and tramadol. The illegal drug heroin and the ”legal drug” Kratom are also treated as opioids. All of these drugs are similar in their actions and consequences.

All of these drugs are extremely powerful. For people with severe pain, some opioids are very effective medicines, and most patients treated for pain with opioids do not become dependent on them. For some people, however, opioid dependence is an unexpected side effect of proper pain treatment. Addiction happens to good people. Not all addicts are recreational abusers. Problems arise when someone is unable to stop using the drug after the cause of the pain has resolved.

Q. Do you prescribe medications to help with withdrawal symptoms while detoxing off of opioids?
A. Yes, usually. So-called “MAT” or medication-assisted treatment. There is no single correct way to detox off opioids. Sometimes sedatives, anti-nausea, even antidepressants, and blood pressure medications are helpful in different stages of this process. Some patients have to be tapered gradually over weeks or even months before the actual discontinuation process starts. One of the most useful techniques involves Suboxone. (Active ingredient buprenorphine.) Buprenorphine is started once withdrawal has begun. Other brands or compounded forms of buprenorphine can make it easier than when dealing with the dosage inflexibility of Suboxone. Buprenorphine also comes in injectable forms for weekly or monthly administration under medical supervision. Another drug, Naltrexone, cannot be taken until opioids are completely out of the body, usually 7 to 10 days after withdrawal begins. Naltrexone works as a deterrent to discourage resuming the use of opioids and to help with cravings.
Q. What is the difference between tolerance, physical dependence, and addiction?

A. It can be difficult to know the difference between tolerance, physical dependence, and addiction.

Tolerance refers to the situation in which a drug becomes less effective over time.

Physical dependence means that a person will develop symptoms and signs of withdrawal (e.g., sweating, rapid heart rate, nausea, diarrhea, goosebumps, anxiety) if the drug is suddenly stopped or the dose is lowered too quickly.

Addiction refers to a condition when a person has lost control over the use of the drug and continues to use it even when the drug is harming themselves or others. People who are addicted engage in unacceptable behaviors like obtaining pain medications from non-medical sources, altering oral formulations of prescription medications, or snorting or inappropriately injecting medications.

Particularly when you have a past or current history or even a family history of substance abuse, the chance of addiction is significant when pain medications are prescribed by a doctor, even when taken as directed. Ask your provider what you should watch for when taking potentially addictive prescription medications.

Q. I have a problem with alcohol. I never go a day without a drink. Can you help?

Specific Questions About Suboxone (And Other Forms of Buprenorphine)

Q. If I decide to be treated with Suboxone (or other forms of buprenorphine), when will I start to feel better?
A. When dosed and administered properly, most patients feel a measurable improvement by thirty minutes, with the significant effects clearly noticeable after about one hour. The full benefit may take days.
Q. How long will Suboxone last?
A. After the first hour, many people say they feel pretty good for most of the next day. Responses to Suboxone will vary based on factors such as tolerance and metabolism, so each patient’s response is different. Your doctor may increase or divide your dose of Suboxone during the first week to help keep you from feeling sick.
Q. Can I go to work right after my first dose?
A. Suboxone can cause drowsiness and slow reaction time. Your ability to drive, operate machinery, and play sports may be affected. Some people go to work right after their first Suboxone dose; however, many people are advised to take the first and possibly the second day off until they feel better. Compared to other opiates, Suboxone causes much less drowsiness and leaves you more alert and functional.
Q. Is it important to take my medication at the same time each day?
A. To make sure that you do not get sick, it is essential to take your medication at the same time every day. The most noticeable effects of the drug last about 24 hours. It is best to take your dose in one sitting, but you do not necessarily need to fit all tablets or films under your tongue simultaneously. The most important thing is to be sure to take the full daily dose you were prescribed. This allows your body to maintain constant levels of buprenorphine. This becomes even more important when it comes time to taper off the drug.
Q. Why does it sometimes only take 5 minutes for Suboxone to dissolve and other times it takes much longer?
A. Many factors (e.g. the moisture of your mouth) can affect that time. Drinking something before taking your medication is a good way to help the tablet dissolve more quickly. Don’t drink anything for at least 10-30 minutes after each dose. Also, the various generics have different absorption rates, as well as the films compared to tablets. If you have had issues with adequate absorption under your tongue during your screening evaluation, you should ask about the injectable forms of buprenorphine that can be administered weekly or even monthly.
Q. What is the difference between Suboxone and methadone?
A. The active ingredient in Suboxone is Buprenorphine. Both Buprenorphine and methadone are technically opiates, i.e., morphine–like drugs. Buprenorphine is a partial agonist. Methadone is a full agonist. Both drugs are useful in treating heroin or other opioid addictions. However, Buprenorphine has many advantages. For details, this download provides additional information.
Q. What happens if I take fentanyl or other pain meds or heroin and then take Suboxone?
A. If you abuse and start while under the influence, you may feel very sick and experience what is called a “precipitated withdrawal.” The naloxone component of Suboxone competes with other opioids and will displace those opioid molecules from the receptors, ONLY WHEN NOT USED AS DIRECTED! Because SUBOXONE has partial opioid effects compared to full agonist opioids, you may go into withdrawal and feel sick.
Q. Can a person currently being treated with methadone switch to buprenorphine (brand name suboxone) without suffering withdrawal symptoms?
A. Patients can switch from methadone to buprenorphine treatment, but because the two drugs are very different. A number of factors affect whether buprenorphine is a good choice for someone who is currently receiving methadone. It is very possible for patients receiving methadone to be switched to buprenorphine under proper medical supervision. Patients interested in finding out more about the possibility of switching treatment should schedule a screening evaluation to learn about the process. Buprenorphine is much easier to taper than methadone, with much less withdrawal, etc.
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