People who have become addicted to opiates like heroin, fentanyl, oxycontin and other powerful narcotics may feel helpless to escape their dependency – once withdrawal rears its ugly head, the painful symptoms can make it virtually impossible, and medically dangerous, to detox without assistance. Fortunately for patients who are trying to eliminate their dependence on illicit drugs, there is help. Many have heard of the methadone maintenance program, but another drug, which has been used for some time in Europe and the U.S., is increasingly being used to help Ontario opiate addicts break free of opiate addiction: suboxone. It is now available in Ontario for opioid addiction therapy.
Before using suboxone
Although suboxone is now available by prescription in Ontario, and is covered by several types of drug plans, there is a definite procedure process before when a patient is approved for enters a suboxone therapy program. Typically, an outpatient harm reduction model is adopted. This would usually include an initial medical exam and testing; a signed contract and treatment plan; addiction counselling and therapies as appropriate; periodic urine testing; daily suboxone doses, including ‘carries’; and post-suboxone treatment as necessary, such as a relapse prevention group.
Suboxone 101
Suboxone is taken in pill form and is comprised of two drugs, buprenorphine and naloxone, in differing strengths. The pill is placed under the tongue (sublingual) to dissolve and the two drug components dissolve at different speeds, allowing the buprenorphine to do its work without making it possible for the pills to be crushed and injected. If a patient attempts to take other narcotic opiates while on suboxone, these drugs would have little to no effect, reinforcing the desire to stay clean since the old high is not obtained. Patients must begin their course of suboxone once they are already in moderate withdrawal.
Suboxone Advantages
While methadone is still widely available in Ontario as a treatment for heroin and opiate addiction, suboxone may be a preferred method for some. Though it is contraindicated for pregnancy, it has a better safety profile overall than the more commonly used methadone; it does not affect heart rhythms and is less likely to cause overdose. Suboxone patients can often get to a maintenance dose immediately, which increases the ability of patients to taper off in a timely manner; it has fewer side effects than methadone, and may be longer acting.
On the other hand, suboxone, though a strong medicine, may not fully block withdrawal symptoms for patients who have been abusing large amounts of opioids. It can also precipitate acute withdrawal and must therefore be used properly under the direction of an experienced physician.
Because suboxone is itself an opioid, it is effective in reducing opiate cravings and withdrawal symptoms, and the drug’s unique composition allows it to deliver these benefits without sedation or interference with a patient’s normal daily activities. For this reason, it is becoming more and more available in Ontario for the treatment of addiction to oxycodone, codeine, morphine, heroin, and other opiates.
