- What is Suboxone?
- What is Buprenorphine?
- What is Naloxone?
- How Buprenorphine Works
- Side Effects
- Duration of Buprenorphine + Naloxone (Suboxone)
- How Long does Saboxone Stay in the Body?
- How Long does Suboxone Block Opiates?
- How Long does Suboxone Stay in our System for Drug Tests?
- Withdrawal Symptoms
- How Long does the Treatment Last?
What is Suboxone?
Suboxone® is a prescription medicine that contains the active components buprenorphine and naloxone.
These two combined medications in each dose of Suboxone are classified into two: Buprenorphine as a partial opioid agonist and Naloxone as an opioid antagonist.
It is indicated for treatment of opioid dependence in adults and should be used as part of a complete treatment plan including counseling and psychosocial support [1,2].
Picture 1: Suboxone Film (sublingual film)
Image Source: Restorative Solutions. Available from:http://restorative.solutions/dodson-directive/
Picture 2: Suboxone Tablets
Image Source: Restorative Solutions. Available from: http://restorative.solutions/dodson-directive/
What is Buprenorphine?
Buprenorphine (pronunciation: ‘bu-pre-‘nor-feen) is an opioid medication used to treat opioid addiction. It is a semi-synthetic opioid from an alkaloid of the poppy Papaver somniferum which is called thebaine.
Buprenorphine is a partial agonist, meaning it produces less side effects like respiratory depression that can only be seen with full agonist opioid.
Formulations of buprenorphine include Suboxone, Buprenex, Subutex, Cizdol, Bunavail, Temgesic, Zubsolv, Butrans, and Norspan available either as buprenorphine hydrochloride alone or a combination of buprenorphine and naloxone [3, 4].
What is Naloxone?
Naloxone (pronunciation: nə-läk-sōn) is a synthetic drug similar to morphine, which blocks the opiate receptors in the nervous system. It works by competitively antagonizing receptors for opioids.
To explain it simply, naloxone binds with the opioid receptors in the brain without stimulating them. It is a drug used to reverse the effects of opioids, especially in overdose. Naloxone is also useful in reducing respiratory or mental depression caused by opioids .
How Buprenorphine Works
- Opioid receptor is empty. A person becomes less sensitive and requires more opioids to produce the same effect if they become tolerant to opioids. The patient feels discomfort whenever there is an insufficient amount of opioid receptors being activated. That is when withdrawal happens.
- Opioid receptors filled with full-agonist. Euphoria and the stop of withdrawal for a period of time (4-24 hours) are caused by the strong opioids of heroin and painkillers. To the point of an uncontrollable addiction, the brain starts to crave opioids and the cycle repeats accelerates.
- Opioid replaced and blocked by Buprenorphine. Buprenorphine battles with the full agonist opioid for the receptor. It has a stronger affinity to receptors that eliminates existing opioids and blocks others from binding.
- As a partial agonist, buprenorphine has a restricted opioid effect, enough to stop withdrawal but not enough in causing intensive euphoria.
- Over time (24-72 hours) buprenorphine dissipates, but still creates restricted opioid effect that is enough to stop withdrawal and continues to block other opioids from binding to the opioid receptors.
The primary side effects of buprenorphine are similar to other opioid agonists, which include the following :
- Headache or other pain;
- Tongue pain, inflammation inside your mouth;
- Increased sweating (diaphoresis); or
- Swelling of the extremities
- Sleep problems (insomnia);
- Diarrhea or dehydration
Duration of Buprenorphine + Naloxone (Suboxone)
The half-life of Suboxone is 20-70 hours, depending on the route of administration and interaction with other drugs administered to the body.
Furthermore, buprenorphine has the capability to stay and attach to opiate receptors for over 24 hours, effectively incapacitating the receptors to make use of other stronger opiates less appealing. [4,7]
How Long does Saboxone Stay in the Body?
This drug has a relatively short half-life.
In most people, it will be undetectable in the urine after 2-4 days of complete abstinence. In saliva, it only stays for 1-3 days. Hair drug tests usually have a longer detection time of 90 days. Suboxone would last in the blood stream the longest. Some people put it at around 17 days, others at longer periods of time.
How long it stays inside the body depends on the dosage, usage, body fat, and metabolism. If you are taking in 8mg of Suboxone, possibly it will take 5 days for the drug to be excreted from your system. With 4mg of Suboxone, it will take 30-72 hours; while it usually takes 24-36 hours for 2mg of Suboxone to be taken out of your body [8,9].
How Long does Suboxone Block Opiates?
Blocking of opiates depends on duration and dosage of the drug administered. A dose of 4 mg once would only block opiates for 1 to 3 days; a dose of 16 mg or more will block opiates for 3 to 5 days.
How Long does Suboxone Stay in our System for Drug Tests?
It depends on the amount of Suboxone taken and the metabolism of a person. Suboxone could stay 3 to 5 days or maybe a week in your system .
Buprenorphine withdrawal symptoms are unpleasant but it depends on the brand of drugs used wherein it could be milder with Subutex than Suboxone. Common withdrawal symptoms include:
- Muscle, joint, and bone pain
- Inability to sleep (insomnia)
- Restless leg syndrome (RLS)
- Excessive sweating (diaphoresis)
- Involuntary shaking (tremors)
- Nausea and vomiting
- Raise blood pressure (hypertension)
- Raised heart rate (tachycardia)
Suboxone withdrawal lasts for 3 months or 90 days. The process usually differs from person to person.
Withdrawal with Suboxone is not going to be easy because of the factors that may influence on how the body gets rid of it. It may vary depending on the dosage and duration of drug intake. The longer you took the drug, the higher the amount of Suboxone in your system, the more difficult it is for you to withdraw.
During the withdrawal process, it is important to engage with healthy activities [11,12].
How Long does the Treatment Last?
Opioid addiction is a manifestation of brain changes resulting from chronic opioid use and misuse. The patient’s recovery is in great part a struggle to overcome the effects of these changes. Brain adaptations take time to develop and reverse.
Patients should remain in treatment long enough to reverse the brain changes to the extent possible and learn coping mechanisms for what cannot be reversed. This is accomplished through deliberate reconditioning effort. 6-12 months is not an unusual treatment time frame, but longer period may be required, depending on the progress of the patient .
Getting off of Suboxone needs a serious medical help. It will not be easy, but indeed, it is possible. However, it is highly recommended to stay as productive and healthy as you can during withdrawal because it brings about faster recovery.
- How is treatment differ from drug abuse. Available from: http://psychcentral.com/lib/how-is-suboxone-treatment-different-than-drug-abuse/
- The National Alliance of Advocates for Buprenorphine Treatment. Available from: http://www.naabt.org/
- Buprenorphine. Available from: https://en.wikipedia.org/wiki/buprenorphine
- Naloxone. Available from: http://www.naloxone.org.uk/index.php/naloxoneseperator/naloxoneinformation/whatisnaloxone
- Side Effects. Available from: http://drugs.com/sfx/buprenorphine-naloxone-side-effects.html
- How long does Buprenorphine stay in your system. Available from: http://www.passadrugtestingforall.com/long-does-buprenorphine-stay-your-system-a-72.html
- How long does buprenorphine last. Available from: http://prescription-drug.addictionblog.org/how-long-does-buprenorphine-last/
- Steadyhealth. Available from: http://www.steadyhealth.com/topics/how-long-does-suboxone-stay-in-your-body-stay-active
- Healthtap. Available from: https://www.healthtap.com/
- The Ugly Truth about Withdrawal. Available from: http://lighthouserecoveryinstitute.com/suboxone-withdrawal-symptoms/
- Withdrawal Symptoms. Available from: http://mentalhealthdaily.com/2014/04/24/suboxone-buprenorphine-withdrawal-symptoms-how-long -do-they-last/
- The National Alliance of Advocates for Buprenorphine Treatment Documents. NAABT brochures.