Suboxone is a (tablet or strip with Buprenorphine and naloxone) and is an FDA approved medication for the treatment of people on heroin or other Opioid addiction. Buprenorphine can be used for detoxification or for maintenance therapy. Maintenance therapy can continue as long as medically necessary. There are other treatments for opiate addiction, including methadone, naltrexone, and some treatments without medications that include counseling, groups and meetings.
If you are dependent on opiates-any opiates-you should be in as much withdrawal as possible when you take the first dose of Buprenorphine. IF you are not in withdrawal, Buprenorphine can cause severe opiate withdrawal. We recommend that you arrange not to drive after your first dose, because some patient’s get drowsy until the correct dose is determined for them. Some patient’s find that it takes several days to get used to the transition from the opiate they had been using prior to Buprenorphine. During this time any use of opiates can or could cause an increase in symptoms. After you become stabilized on Buprenorphine, it is expected that other opiates will have less effect. Attempts to override the Buprenorphine with taking more opiates can or could result in an opiate overdose. You should not take any other medication without discussing it with the physician first and foremost.
Combining Buprenorphine with alcohol or other sedating medications is dangerous. The combination of Buprenorphine with benzodiazepines; such as: (Valium, Librium, Ativan, Xanax, Klonopin. ECT) has resulted in DEATHS. The form of Buprenorphine (Suboxone) you will be taking is a combination of Buprenorphine with a short acting opiate blocker (Naloxone). It will maintain physical dependence, and if you discontinue it suddenly, you will likely experience withdrawal. If you are not already dependent, you should not take Buprenorphine as it could eventually cause physical dependence.
Buprenorphine tablets/strips must be held under the tongue until they dissolve completely. It is important not to talk or swallow until all is dissolved. This process can take up to ten minutes. Then the medication is then absorbed over the next 30 to 120 minutes from the tissue under the tongue. Buprenorphine will not be absorbed from the stomach if it is swallowed. If you swallow the tablet/strip, you will not have the important benefits of the medication, and it may not relieve your withdrawal. Most patients end up at a daily dose of 16 mg to 24 mg of Buprenorphine. (This is roughly equivalent to 60 mg of methadone maintenance). Beyond that does, the effects of Buprenorphine plateau, so there may not be any more benefit to increase in dose. It may take several weeks to determine just the right dose for you. The first dose is usually 8mg.
If you are transferring to the Suboxone from methadone maintenance, your dose has to be tapered until you have been below 30mg for at least a week. There must be at least 24 hours (preferably longer) between the time you take your last methadone dose, and the time you are given your first dose of Buprenorphine. Your doctor will examine you for clear signs of withdrawal, and you will not be given Buprenorphine until you are in withdrawal.
I have read and understand these details about Buprenorphine treatment, including risks and benefits. I understand there are alternatives and wish to be treated with Buprenorphine.