The not-so-good news: this is a long process, and is not easy. You and your partner have likely been through many rough times to get to the point where they were willing to seek treatment, but getting help doesn’t mean the addiction is resolved immediately.
If your partner was addicted to pain killers or heroin, suboxone is often the drug of choice to help your partner break the addiction. Suboxone treatment is different from going “cold turkey”–which can be extremely dangerous–or from methadone maintenance, which requires your partner to present to a clinic every day to receive the medication. Suboxone is available to be dispensed by a pharmacy, and your partner can take it at home. It is also unlikely to be abused, like methadone can, because of how it works in the brain.
How does suboxone work?
Suboxone is comprised of two separate medications: buprenorphine and naloxone. Buprenorphine is a partial opioid agonist, meaning its opioid effects are significantly reduced compared to that of full opioid agonists, such as vicodin or heroin. The naloxone in suboxone is in place to prevent the misuse of suboxone by injection drug users. The combination of these two medications leads to suboxone’s effectiveness in treating opioid dependence, because when on this medication, your partner cannot get the high they would get if they were to misuse an opiate drug.
What happens once my partner is on suboxone?
At first, your partner will be given the initial doses by a doctor who is approved to dispense suboxone. (Not every doctor can do this.) Ideally, your partner will be in partial withdrawal when this happens, meaning that they used an opiate within the past few days, but are not in full withdrawal yet. Once your partner and their doctor determine a “maintenance level” of the drug, meaning a dosage where your partner is comfortable and functioning fairly well, they will take the suboxone once daily, usually in the morning. At that point, it is up to your partner how long they want to remain on the suboxone. When your partner decides with their doctor that they can stop taking the suboxone, the doctor will provide a tapering schedule (usually 2-4 weeks) until your partner is no longer taking the drug. Theoretically, at that point, your partner is free of opiate addiction.
What’s the other side of the story?
So, the previous sections are the “ideal” of kicking an opioid addiction. If you have lived with someone who is addicted to drugs, you know it’s not that easy to kick a habit like that. Here are some of the pitfalls of suboxone treatment:
- Many people believe taking suboxone is just “trading one drug for another,” and are resistant to the idea. They are right in that suboxone works in the brain much like the full-force opiates do, but suboxone is a controlled prescription medication, and does work to reduce the cravings over time so that your partner’s brain does not need to get high.
- Finding a doctor who can prescribe the suboxone and provide appropriate guidance and follow-up is challenging. As previously mentioned, suboxone can only be prescribed by doctors who have received special permission to do so, and they are limited by federal law to only 100 suboxone patients at any given time. If you are in an area of the country where there are not many doctors, being able to receive this treatment may be difficult.
- Your partner also needs counseling to deal with the psychological effects of drug addiction. It’s nice to think that taking a drug to stop a drug habit will resolve everything, but that just takes care of the physiological side of things. There is still the issue of why your partner felt the need to take drugs to get high in the first place. Many people are resistant to the idea of drug treatment–whether it’s outpatient, intensive outpatient, rehab, or inpatient–but if your partner is going to suboxone route, they need to be in counseling as well. Most places that prescribe suboxone require it as part of the deal for getting the prescription anyway.
- Suboxone can be abused as well. Although it is not as potent as the full opiate agonists, the truth is that suboxone can be abused to get a high, too. Some people may use suboxone in conjunction with other substances to increase the effects, which can be dangerous. These substances include benzodiazepines (like klonopin), sleeping pills, alcohol, tranquilizers, other opiate medications, and antidepressants. Combining these drugs could cause extreme sedation and drowsiness, unconsciousness, and death. This is especially true if patients use injection as their method of administration.
- There are side effects to suboxone. Like any prescription medication, side effects are common. Your partner may find them intolerable. Common side effects of suboxone are nausea/vomiting, insomnia, sweating, headache or other pain, muscle cramps, and constipation.