Family members of patients who have been prescribed Suboxone or buprenorphine for
treatment of addiction often have questions about this treatment.
What is an opioid?
Opioids are addictive narcotics in the same family as opium and heroin. This
includes many prescription pain medications, such as Codeine, Vicodin,
Demerol, Dilaudid, Morphine, Oxycontin, and Percodan. Methadone,
buprenorphine and Suboxone are also opioids.
Why are opioids used to treat addiction?
Many family members wonder why doctors use buprenorphine to treat opiate
addiction, since it is in the same family as heroin. Some of them ask,”Isn’t this
substituting one addiction for another?” But the medications used to treat
addiction to heroin – methadone and buprenorphine – are not “just substitution.”
Many medical studies since 1965 show that maintenance treatment helps keep
patients healthier, keeps them from getting into legal troubles, and prevents them
from getting AIDS.
What is the right dose of buprenorphine , Suboxone?
Family members of patients who have been addicted to heroin or prescription
opioids have watched as their loved ones use a drug that makes them high, or
loaded, or have watched the painful withdrawal that occurs when the drug is not
available. Sometimes the family has not seen the ‘normal’ person for years. They
may have seen the patient misuse doctors’ prescriptions for narcotics to get high.
They are rightly concerned that the patient might misuse or take too much of the
Suboxone prescribed by the doctor. They may watch the patient and notice
that the patient seems drowsy, or stimulated, or restless, and think that the
buprenorphine will be just as bad as heroin.
Every opioid can have stimulating or sedating effects, especially in the first
weeks of treatment. The ‘right’ dose of buprenorphine is the one that allows the
patient to feel and act normally. It can sometimes take a few weeks to find the
right dose. During the first few weeks, the dose may be too high, or too low,
which can lead to withdrawal, daytime sleepiness, or trouble sleeping at night.
The patient may ask that family members help keep track of the timing of these
symptoms, and write them down. Then the doctor can use all these clues to
adjust the amount and time of day for buprenorphine doses.
Once the right dose is found, it is important to take it on time in a regular way, sothe patient’s body and brain can work well.
Friday, February 8, 2008
Sunday, February 3, 2008
How Opioids and Buprenorphine Work
Heroin...methadone...Oxycontin...What do these three drugs have in common? Like many other drugs --both legal and illegal --they are all a type of drug called opioids.
How opioids work
1. The opioid enters your bloodstream and is carried to your brain.
2. Brain cells that have an opioid attached to them behave differently than brains cells that do not. All of the feelings associated with taking an opioid --feeling high, lightheaded, or sleepy along with an overall feeling of wellbeing.
How buprenorphine works
Buprenorphine is a kind of opioid, but it works a little bit differently --and in a way which makes it very useful for treating opioid dependence.
1. Like other opioids, buprenorphine enters the bloodstream and is carried to the brain.
2. While buprenorphine does change the way your brain cells work, it does not change them as much as many other opioids. So, buprenorphine controls craving for opioids and will also give you a feeling of wellbeing and make the opiate addict feel normal again.
3. Buprenorphine attaches to opioid receptors much more tightly than other opioids. If you take buprenorphine and then another opioid, you will not feel much of an effect from the other opioid. This is because the buprenorphine stays on the opioid receptor and the other opioid
cannot bind to it.
If you take another opioid and then take buprenorphine, the buprenorphine can knock the other opioid off the receptor and take its place. If this happens, you can go into withdrawal. To avoid going into precipitated withdrawal, your physician will instruct you not to take opioids for several hours before beginning on buprenorphine. Also, you should not take other opioids while you are on buprenorphine maintenance.
How opioids work
1. The opioid enters your bloodstream and is carried to your brain.
2. Brain cells that have an opioid attached to them behave differently than brains cells that do not. All of the feelings associated with taking an opioid --feeling high, lightheaded, or sleepy along with an overall feeling of wellbeing.
How buprenorphine works
Buprenorphine is a kind of opioid, but it works a little bit differently --and in a way which makes it very useful for treating opioid dependence.
1. Like other opioids, buprenorphine enters the bloodstream and is carried to the brain.
2. While buprenorphine does change the way your brain cells work, it does not change them as much as many other opioids. So, buprenorphine controls craving for opioids and will also give you a feeling of wellbeing and make the opiate addict feel normal again.
3. Buprenorphine attaches to opioid receptors much more tightly than other opioids. If you take buprenorphine and then another opioid, you will not feel much of an effect from the other opioid. This is because the buprenorphine stays on the opioid receptor and the other opioid
cannot bind to it.
If you take another opioid and then take buprenorphine, the buprenorphine can knock the other opioid off the receptor and take its place. If this happens, you can go into withdrawal. To avoid going into precipitated withdrawal, your physician will instruct you not to take opioids for several hours before beginning on buprenorphine. Also, you should not take other opioids while you are on buprenorphine maintenance.
Friday, February 1, 2008
Suboxone And Pregnancy
Suboxone and Pregnancy - What you need to Know.
Abusing heroin or prescription painkillers while you are pregnant is very dangerous --both for your own health and for the health of the baby you are carrying. The best action you can take is to get into treatment and stop using drugs.
Unfortunately, medical researchers haven't done enough research yet to know for sure if Suboxone is safe to use during pregnancy. Even though early tests do suggest that this medication is probably safe during pregnancy, there might be some rare, serious consequences for you or for your baby.
What happens if you are pregnant (or want to become pregnant) and want to start taking Suboxone?
Unfortunately, you should avoid using Suboxone if you are pregnant or want to become pregnant. In this situation, use Suboxone only if you can't reasonably choose a different treatment.
Methadone maintenance treatment is safe to use during pregnancy and is a good alternative to Suboxone.
Drug-free treatments, naltrexone treatment, or "detox" are also good choices if you are just planning a pregnancy, but they are a bad idea if you are already pregnant --these treatments will force you to go into withdrawal, which could cause a miscarriage.
Your doctor can advise you about other treatments and help you choose one that it right for you.
What happens if you are already using Suboxone and want to get pregnant?
If you want to get pregnant, the safest thing to do is switch to another treatment that is safe to use during pregnancy -- methadone, naltrexone, or a drug-free treatment.
Let your doctor know in advance if you want to become pregnant so you can work together to plan your change in treatment. Also, use birth control to reduce the chance of having an unplanned pregnancy.
But what happens if you are taking Suboxone and get pregnant unexpectedly?
In this situation, you have 2 things to consider:
There is a small chance that Suboxone will hurt your child, but
If you switch from Suboxone to any other kind of treatment (except for Subutex –
see below, you will probably go into withdrawal --and withdrawal could cause a miscarriage.
Miscarriage from withdrawal is the greater of these 2 risks. So, if you are already on Suboxone and you become pregnant, you should not switch to another treatment.
There is only one change you should make --your doctor will probably switch you from Suboxone to a drug called Subutex.
Subutex has the same active ingredient as Suboxone and is used in the same way, but it doesn't have another ingredient (naloxone) which could be dangerous to take during pregnancy. Remember to talk to your doctor if you wish to become pregnant or suspect you are pregnant at any time while taking Suboxone.
Abusing heroin or prescription painkillers while you are pregnant is very dangerous --both for your own health and for the health of the baby you are carrying. The best action you can take is to get into treatment and stop using drugs.
Unfortunately, medical researchers haven't done enough research yet to know for sure if Suboxone is safe to use during pregnancy. Even though early tests do suggest that this medication is probably safe during pregnancy, there might be some rare, serious consequences for you or for your baby.
What happens if you are pregnant (or want to become pregnant) and want to start taking Suboxone?
Unfortunately, you should avoid using Suboxone if you are pregnant or want to become pregnant. In this situation, use Suboxone only if you can't reasonably choose a different treatment.
Methadone maintenance treatment is safe to use during pregnancy and is a good alternative to Suboxone.
Drug-free treatments, naltrexone treatment, or "detox" are also good choices if you are just planning a pregnancy, but they are a bad idea if you are already pregnant --these treatments will force you to go into withdrawal, which could cause a miscarriage.
Your doctor can advise you about other treatments and help you choose one that it right for you.
What happens if you are already using Suboxone and want to get pregnant?
If you want to get pregnant, the safest thing to do is switch to another treatment that is safe to use during pregnancy -- methadone, naltrexone, or a drug-free treatment.
Let your doctor know in advance if you want to become pregnant so you can work together to plan your change in treatment. Also, use birth control to reduce the chance of having an unplanned pregnancy.
But what happens if you are taking Suboxone and get pregnant unexpectedly?
In this situation, you have 2 things to consider:
There is a small chance that Suboxone will hurt your child, but
If you switch from Suboxone to any other kind of treatment (except for Subutex –
see below, you will probably go into withdrawal --and withdrawal could cause a miscarriage.
Miscarriage from withdrawal is the greater of these 2 risks. So, if you are already on Suboxone and you become pregnant, you should not switch to another treatment.
There is only one change you should make --your doctor will probably switch you from Suboxone to a drug called Subutex.
Subutex has the same active ingredient as Suboxone and is used in the same way, but it doesn't have another ingredient (naloxone) which could be dangerous to take during pregnancy. Remember to talk to your doctor if you wish to become pregnant or suspect you are pregnant at any time while taking Suboxone.
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