Suboxone.Drug treatment in hospitals or drug rehab facilities is beneficial in some situations of Addiction and Alcoholism but in the case of pain killers addiction and other opiates abuse problems, our outpatient drug treatment program can be as effective, offering private personalized and comfortable opiate detox and maintenance treatment. Our outpatient drug treatment program combines Suboxone and behavioral therapy to treat Pain Killers addiction and abuse with minimal or no disruption to your work, social or family life. more
Get Help Now! Call 1-888- Suboxone or 1-888-782-6966
What is Buprenorphine?
Also known as Suboxone and Subutex, it is an FDA approved medication for office based treatment of opiate addiction. It reduces opiate withdrawal symptoms and cravings during the treatment of pain killer addiction. more info
Combined with appropriate behavioral counseling Buprenorphine, Suboxone and Subutex, can be very effective in treating dependence to opiates and other Pain killers addictions and abuse.
DATA 2000 approved office based treatment of opiate and pain Killers addictions. The FDA approved "Suboxone" for such purposes in the end of 2002 and the medication became available for use soon thereafter.
Suboxone is a partial opiate (partial agonist) a quality that makes it relatively safer than full opiates (full agonists). This enables physician to use it on outpatient basis without the need for hospitalization for treatment of Pain killers addiction and abuse. For further information about Buprenorphine, Suboxone and Subutex please check the manufacturing company's website at www.Suboxone.com
When Suboxone is kept under the tongue, only very little quantity
of naloxone enters the bloodstream of the patient and when it is
injected, naloxone would cause severe withdrawal symptoms in
patients with opiate dependence.
Suboxone is usually administered as a single daily dose by placing the tablet under the tongue or as prescribed by the physician. It will usually take at least ten minutes for the tablet to dissolve completely in the mouth. It is advisable not to chew or swallow the tablets as this may not give the desired result. This medicine should not be taken soon after taking a full or partial opioid drugs.
Suboxone is a combination of Buprenorphine and Naloxone. The former is a partial opiate and the euphoric effects are less than with full opiates; also the habit forming potential is lower and therefore it is much easier to stop taking this medicine than other full opiates, such as morphine and heroin. The latter component, naloxone, is an opiate antagonist that is mainly active if Suboxone is injected, hence it acts as a deterent to injecting those tablets.
Suboxone should be avoided in patients who are allergic to opioids and should not be taken in combination with other opiates, alcohol, benzodiazepines or other CNS depressants. There is a long list of interactions that physicians should be aware of and can be found at the manufacturer website. Caution and monitoring may need to be exercised in patients with Hepatitis C. Common side effects might include headaches, sleep disorders, constipation and sweating.
As with full opiates Suboxone Overdosage can lead to severe complications including death and disability. Most common cause of Buprenorphine related deaths is due to injecting of the medicine and/or taking it with alcohol, sedatives or CNS depressant.
For detailed and accurate information about Suboxone please visit the manufacturer website at www.Suboxone.com
Suboxone Doctors conducting Detoxification
It is a great medication for opiate dependence however Suboxone should be part of a comprehensive Suboxone clinic program that also includes education, counseling and intervention.
Suboxone detoxification from dependence on pain killers is only the first step in treatment. This should be followed by an education program about addiction, substance abuse, the disease, risk factors, your predisposing conditions and treatment. Counseling is also an integral part of the equation in order to prevent relapses.
Suboxone detox is not a treatment by itself. Instead, its primary purpose is to alleviate the uncomfortable effects of withdrawals and cravings to opiates while the patient is relearning how to live without opiates. This should be followed by long-term treatment that may be in the form of abstinence or long term maintenance using Suboxone or methadone along with behavioral therapy.
1-888-Suboxone or 1-888-782-6966
Suboxone Doctors treating PainKiller Addiction
In 2007 the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health, has launched the first national study evaluating Suboxone as a treatment for addiction to prescription painkillers such as Oxycodone, hydrocodone, hydromorphone and others.
The importance of Suboxone as a modality to treat pain killer addiction stems from the most recent findings. The latest National Surveys has found the incidence of nonmedical new use of pain killers to be 2.2 million Americans aged 12 and older, surpassing the number of new marijuana abusers. These numbers by far exceed those reported for heroin, cocaine, ecstasy and amphetamines combined together.
The study will test the efficacy of Suboxone combined with various forms of counseling in patients with addiction to prescription pain killers. Suboxone blocks and weekly activate the Mu receptors in the nervous system which are the same receptors that are activated by pain killers and other opiates.
Suboxone has a strong affinity for binding to those Mu receptors and can actually displace most other opiates from the receptor site. However, once it attaches to the receptors it provides a low intrinsic activity hence producing a much less intense opiate agonistic effect.
The Suboxone study will be conducted across 11 locations throughout the United States enrolling up to 648 patients. They would include those who became addicted to pain killers due to a medical reason and those who became addicted to pain killers due to recreational use. One of the purposes is to study whether or not both categories would respond to Suboxone treatment in the same manner.
All patients in the study will be placed on Suboxone for one month then the tapered off. If they relapse the treatment will be repeated for three months and then tapered off again. Alongside Suboxone treatment the effectiveness of intensive versus brief counseling will be studied. For more information on this study please visit the National Institute of Health website.
1-888-Suboxone or 1-888-782-6966
To elaborate on the importance of Suboxone in this era lets discuss another study, which found that more than 12 percent of those between the age of 18 and 25 have used painkillers for non-medical purpose within the year 2004-2005. Almost 2 percent of this age group were also found to be already dependent on these medications. We believe that this is one of the important instances when Suboxone should be used before the problem escalates to full blown addiction.
One of the interesting findings was that more than half of those young adults obtained those painkillers from a relative or from a friend, in some occasions free of charge. Interestingly enough a similar phenomenon has been reported by some on Suboxone were one patient lends another one of their pills to help with their withdrawal symptoms. This practice is illegal and should not be encouraged. This medicine should only be prescribed or dispensed under the supervision of a qualified qualified Suboxone doctor.
The Buprenorphine Summit- cont.
One of the findings was that out of around 47000 emergency room visits related to opioid analgesics less than 1 % was attributed to Suboxone medication. This result was unweighted and reported by the DAWN program.
Another study by the clinical trial network showed that continuing Suboxone in addition to counseling was more effective than detoxification with counseling. This confirms the thought that detoxification is not a treatment on its own and that Suboxone treatment can be very effective in the recovery process when combined with behavioral interventions.
In the RADARS system of the Rocky mountains studied Suboxone abuse and diversion as well as mortality data and pediatric exposure abstracted from their poison center data. The prescription drug abuse data was derived from a total of six views, law enforcement, key informants, opioid treatment programs, impaired healthcare workers, college surveys and off-course the poison center. They defined the stages of dependency into Oportunity then use, then abuse, then dependence and eventually remission.
Interestingly Suboxone was found to represent less than 5% of opioids abuse among patients enrolled in methadone programs and around 12% of opioid abused by college students. Taken it orally was the most frequent route of abuse followed by injecting it. Lets not forget that diversion of Buprenorphine was done to stop withdrawal symptoms rather than to get high in 30% of the reports obtained by a national study.
In regards to mortality in ages 17 to above 50 year old patients, this study found that only 5 cases was related to Buprenorphine while methadone related deaths was 126 cases during the same time period. This indicates that Suboxone is a relatively safer medication when compared to other opiates.
When it comes to pediatric exposures between the year of 2003 till 2006, only 175 cases were exposed to Buprenorphine compared to almost 6000 kids were exposed to hydrocodone. Again we can see here the relatively lower risk of Suboxone.
That study concluded that although Buprenorphine diversion and abuse appears to be occurring in many areas of the united states it seems to be localized. Also although the pattern of Suboxone diversion and abuse may follow other opiates it appears that it has stabilized or decreased since the year of 2006.
Another study presented in the Summit looked at Buprenorphine in pregnancy compared to methadone. According to these findings, the neonatal abstinence syndrome, which is the withdrawal symptoms that the babies may suffer after birth by a mother taking opiates, was significantly lower in the Buprenorphine group. That was also true for the neonatal hospital stay. Please note that Suboxone is not FDA approved for use in pregnancy.
They concluded that transitioning patients to Buprenorphine may provide an improved outcome that could be due to increased access to treatment. Also that as the medication is being used more in the community its use in pregnancy may also increase and that no long term outcome studies for neonates are available. It seems to us that the team in this study used Subutex during pregnancy and switched to Suboxone after birth, however we could not confirm this assumption.
Suboxone for Pain killers addiction
Treatment at home.
With Suboxone many cases of opiate dependence may not need drug rehab or daily follow up visits. more
Suboxone help you avoid diarrhea, cold sweats, anxiety, aches, goose bumps and trouble sleeping so that you can immediately go on with your life. more info
Private, personalized recovery from Vicodin, Lortab, hydrocodone, Oxycontin, Percocet, Norco, Methadone and other opiates even Heroin. more info
Prescription Pain KillersPain Killers are a group of medications indicated to treat genuine pain syndromes that are not responding adequately to non-habit forming medications. Prescription pain Killers side effects are numerous and include but not limited to potential for abuse and respiratory center depression that can be fatal. more
Pain Killers examples include: Actiq - Codeine - Darvocet- Fentanyl- Heroin - Hydromorphone Methadone - Morphine Sulfate - Oxycodone - OxyContin Propoxyphene - Sufentanil - Talwin Vicodin more info
Suboxone has been used over the past few years for both maintenance and detoxification in outpatient, inpatient and rehab settings. We have found it to be most useful in the office based settings where patients can recover from opiate dependence without being confined to a hospital or a drug rehab.
In order for physicians to be able to prescribe or dispense Suboxone for the treatment of opiate dependence they have to obtain a waiver to do so from the department of Health and Human Services.
Suboxone Treatment Evaluation
The Substance Abuse and Mental Health Service Administration has recently conducted a 3 year evaluation of the impact of the Suboxone (Buprenorphine) Waiver program the results of which can be found at SAMHSA’s website. The study which was concluded in November 2005 found that the medication has several properties that offer a significant advantage over other medications used in treatment of opiate dependence.
This evaluation also found that Suboxone appears to have a high safety profile and severe interruption of breathing, a side effect that can happen with any opiate, is rare (but may occur in certain situations. Suboxone can produce some physical dependence albeit of low level of severity and stopping the medicine after prolong use may result in only mild withdrawal symptoms.
Looking at the effectiveness of Suboxone the study found it to be comparable to methadone. Therefore the availability of the former medication has the potential to significantly increase patient’s access to a much needed treatment.
Diversion of Suboxone is and will always be a concern. The study showed that there was little evidence of diversion of Buprenorphine as reported by patients and physicians and that and more studies are needed to determine the true level of diversion and the cause for it.
Suboxone and Addiction
When opiates are used in the proper medical context addiction is very rare. However, physical dependence on pain killers is a known side effect when these medications are taken for even a few weeks in some patients. Physicians who prescribe them should have an EXIT strategy to wean patients off them so that psychological dependence, or addiction, can be prevented. We have used Suboxone for that purpose with great results.
Once addiction develops, biochemical changes at the level of the brain cells take place. Whether these changes ever revert to normal or not is still to be determined, however studies have shown that Suboxone can significantly alter those changes.
Addiction is a very complex disorder; hence treatment has to be as sophisticated and usually entails the combination of Suboxone and behavioral therapy. This disease has genetic predisposing factors that can result in the lower ability to handle stress, neediness, low self esteem, low self satisfaction or others. Psychosocial and Environmental factors form the second prong of addiction. They develop throughout the growing years, become stronger and mature as the patient goes into adolescence. Behavioral interventions rather than Suboxone are the primary approach to deal with this part of the disease.
Suboxone alone is not a sufficient treatment for opiate addiction. For most patients, counseling both individual and
group as well as participation in self-help programs are essential components of
comprehensive treatment programs.
Physicians who choose to treat opiate addiction with Suboxone should at a minimum have some knowledge about the principles of brief intervention and relapse prevention.
In fact, DATA 2000 requires that when physicians apply to SAMHSA for the waiver to prescribe and dispense Suboxone for opioid addiction treatment, they must attest to their ability to refer patients for appropriate counseling and other components of behavioral therapy.
In addition a research conducted by the University of Vermont in Burlington concluded that one of the findings was that combining Suboxone (buprenorphine tablets in the trial) with behavioral therapy was significantly more effective in treating opiate-dependent adolescents compared to combining clonidine with behavioral therapy.
In 2005 a NIDA funded study looked at Network therapy in addition to Suboxone. It was found that outpatient therapy that involves family and friends enhances abstinence among patients receiving buprenorphine for outpatient treatment of opiate addiction. By the end of the 18 week study the abstinence rates in those patients receiving network therapy was twice as high compared to those patients receiving Suboxone alone.
1-888-Suboxone or 1-888-782-6966
The national household survey in 2006 showed that the painkiller abuse continues to increase among those aged 12-17. Suboxone may play a great role in combating this problem. 6.4 percent of young people in this age group have used painkillers for non-medical reasons. These are very disturbing facts and the timing for Suboxone is very appropriate.
Also more first time users have abused painkillers that any other drug. 2.2 million young adults have used painkillers for the first time in the 2006 survey which exceeds the number of first time users of Marijuana and cocaine. Public as well as professional education on the value of Suboxone in treatment of this disease can greatly help attenuate this phenomenon.
This rising prevalence of painkiller dependence prompted leaders in the medical field to call on physicians to educate their patients on the availability of Suboxone for outpatient treatment of this disease.
The 2008 Buprenorphine Summit
To study the progress, success and barriers to Suboxone treatment a group of experts from all clinical and research fields came convened in a Buprenorphine Summit last February, 2008 in Washington D.C. For the sake of discussion on this web site we will refer to this meeting as the Suboxone summit.
The 2008 Buprenorphine Summit had several goals primarily to build upon the finding of last 2 summits, In the Suboxone Summit SAMHSA and NIDA brought together leaders in the fields of Addiction, Pharmacology, Toxicology and Epidemiology to suggest policies to increase access to Suboxone and improve quality of care.
Those experts were divided into 6 working groups to study different aspects of the use of Suboxone for treatment of opioid dependence. Pros and cons on patients, physicians, families, communities and the nation were discussed. Issues like treatment models, protocols, effectiveness, side effects, morbidity and mortality and diversion of Suboxone were among the many topics studied by the work groups.
1-888-Suboxone or 1-888-782-6966
SAMHSA (Substance Abuse and Mental Health Service Administration) is also studying the efficacy of the use of Suboxone on the previously addicted inmates and the role of it in post-release patients in community heath Center. Soft Landing's medical director, Dr. Fahmy is the medical director in one of SAMHSA major grants conducted in the west side of Chicago that aims at prevention and linkage to treatment of HIV, Hepatitis C and substance abuse patients including the use Buprenorphine in the post incarcerated patients as they re-enter into the community, the Westside Connect project. He is also the principal investigator in the SBIRT grant for the residency programs in Chicago.
SAMHSA also continues to evaluate the effectiveness of Suboxone in Special populations including prescription pain killer addictions also effects on teenagers and pregnant women. In doing so they have created the Addiction Technology Transfer Centers that works with other authorities to establish these initiatives.
In addition NIDA ( National Institute on Drug Abuse) and SAMHSA have joined forces to develop the Blending Initiative. The purpose of such effort is to bring the cutting edge research findings into clinical practice in order to provide the standard of care in addiction treatment including the use of Suboxone to the patients who need it most.
The blending teams would be composed of community substance abuse providers working with SAMHSA's ATTC to develop training curricula derived from the research work of NIDA and its subsidiaries. Again from discussion with some of the parties involved we have concluded that proper utilization of Suboxone treatment for opiate dependency.
One of the presentation in this event looked at the history of Buprenorphine use and found that more than one hundred and ninety thousand patients have received the medication so far and that the Northeast US has the greatest prescription rate. They also found the five percent of doctors are now using Suboxone to treat pain. Additionally they determined that doctors are becoming more aware of the fact that Buprenorphine is being illegally traded on the street by patients in opiate treatment programs. The Baltimore health commissioner stated in an interview that most of addicts buying this medication off the street do so to avoid withdrawals rather than getting high, which is a fact that we also believe is true. However, interviews conducted with drug abuse patients in Mass. supported that one third of these patients use this medication to get high.
JAMA article about Suboxone
In November 2008 the Journal of the American Medical Association published an article comparing extended vs short-term Buprenorphine-Naloxone or Suboxone for treatment of opioid-addicted youth.
This trial was conducted in 6 community programs from 06/2003 till 12/2006 and included 152 young patients between 15 and 21 years of age who were randomly given Suboxone for 12 weeks or 14 days tapering dose.
The group that was on Suboxone for 3 weeks were give 24 mgs for 9 weeks and then the dose was tapered over the following 3 weeks, while the other group was raised to 14 mg then the dose was tapered off over 14 days. Both groups were offered behavioral counseling.
Many of the patients reading these findings who previously were or currently are taking Suboxone might already conclude the outcome because they would know that long term treatment would be much preferred than a 14 day taper.
Anyway, those patients received urine drug testing at weeks 4, 8 and 12. At the end of the 12 weeks, only 16 out of 78 patients in the 14 day group remained in treatment but in the 12 week group 52 of the 78 remained in treatment as they were still using Suboxone.
However, at the follow up visit and after both groups were taken off Suboxone, high level of opioid use was found ion both groups. What is really scary is that 4 new Hepatitis C cases were found at the follow up of these young patients. These patients had tested negative for Hepatitis C at the beginning of treatment. This tells us that prompt use of Suboxone and for an extended duration of time may prevent Hepatitis C in patients addicted to opioids.
1-888-Suboxone or 1-888-782-6966