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.
Friday, January 25, 2008
What is Opiate Addiction/ Dependence?
Opiate Addiction/ Dependence
Taking strong opioid painkillers, in large doses,
for an extended period of time, can cause
physical dependence in humans. This means
when the medication is discontinued abruptly,
withdrawal symptoms occur. This is normal
physiology and does not require addiction
treatment. However, if an uncontrollable
compulsion develops and is accompanied by an
increased quantity of drug to achieve the same
effect, and opioid use continues despite negative
consequences, such as loss of a job, then these
conditions may be considered addiction and may
require treatment.
Opioid addiction is a brain disease
Opiate Addiction Is a Brain Disease
Opioid addiction is a treatable chronic brain
disease precipitated by fundamental, long-term,
changes to the structure and functioning of this
organ. Once someone becomes addicted, areas
of the brain are altered from the normal healthy
state. This is why addiction is classified as a
disease. These are physical changes to the brain –
not caused by lack of morals, controlled by
willpower, nor cured by good advice. It’s a disease
as is diabetes or cancer, and it is treatable.
The Drug Addiction Treatment Act of 2000 (DATA2000)
The Act enables qualified physicians to prescribe
and/or dispense opioid medications for the purpose
of treating opioid dependency (addiction). For the
first time in over 30 years, physicians are able to
treat this disease from their private offices or other
clinical settings. This presents a very desirable
treatment option for those who are unwilling or
unable to seek help in drug treatment clinics.
Patients can now be treated in the privacy
of their doctor’s office. One medication doctors
may now prescribe for treating Opiate addiction is
Suboxone also known as Buprenorphine.
Thursday, January 24, 2008
Suboxone - Frequently Asked Qustions
This is a list of the most common asked questions for individuals begining Suboxone Treatment, If you or someone you know has any additional qustions about Suboxone Treatment feel free to post a comment on this blog and I will personally answer your questions dealing with Suboxone.
1. Why do I have to feel sick to start the medication for it to work best?
When you take your first dose of SUBOXONE, if you already have high levels of another opioid in your system, the SUBOXONE will compete with those opioid molecules and replace them at the receptor sites. Because SUBOXONE has milder opioid effects than full agonist opioids, you may go into a rapid opioid withdrawal and feel sick, a condition which is called "precipitated withdrawal."
By already being in mild to moderate withdrawal when you take your first dose of SUBOXONE, the medication will make you feel noticeably better, not worse.
2. How does SUBOXONE work?
SUBOXONE binds to the same receptors as other opioid drugs. It mimics the effects of other opioids by alleviating cravings and withdrawal symptoms. This allows you to address the psychosocial reasons behind your opioid use.
3. When will I start to feel better?
Most patients feel a measurable improvement by 30 minutes, with the full effects clearly noticeable after about 1 hour.
4. How long will SUBOXONE last?
After the first hour, many people say they feel pretty good for most of the day. Responses to SUBOXONE will vary based on factors such as tolerance and metabolism, so each patient’s dosing is individualized. Your doctor may increase your dose of SUBOXONE during the first week to help keep you from feeling sick.
5. Can I go to work right after my first dose?
SUBOXONE can cause drowsiness and slow reaction times. These responses are more likely over the first few weeks of treatment, when your dose is being adjusted. During this time, your ability to drive, operate machinery, and play sports may be affected. Some people do go to work right after their first SUBOXONE dose; however, many people prefer to take the first and possibly the second day off until they feel better.
If you are concerned about missing work, talk with your physician about possible ways to minimize the possibility of your taking time off (eg, scheduling your Induction on a Friday).
6. Is it important to take my medication at the same time each day?
In order to make sure that you do not get sick, it is important to take your medication at the same time every day.
7. If I have more than one tablet, do I need to take them together at the same time?
Yes and no—you do need to take your dose at one "sitting," but you do not necessarily need to fit all the tablets under your tongue simultaneously. Some people prefer to take their tablets this way because it’s faster, but this may not be what works best for you. The most important thing is to be sure to take the full daily dose you were prescribed, so that your body maintains constant levels of SUBOXONE.
SUBOXONE (buprenorphine HCl/naloxone HCl dihydrate)sublingual tablet
8. Why does SUBOXONE need to be placed under the tongue?
There are two large veins under your tongue (you can see them with a mirror). Placing the medication under your tongue allows SUBOXONE to be absorbed quickly and safely through these veins as the tablet dissolves. If you chew or swallow your medication, it will not be correctly absorbed as it is extensively metabolized by the liver. Similarly, if the medication is not allowed to dissolve completely, you won’t receive the full effect.
9. Why can’t I talk while the medication is dissolving under my tongue?
When you talk, you move your tongue, which lets the undissolved SUBOXONE "leak" out from underneath, thereby preventing it from being absorbed by the two veins. Entertaining yourself by reading or watching television while your medication dissolves can help the time to pass more quickly.
10. Why does it sometimes only take 5 minutes for SUBOXONE to dissolve and other times it takes much longer?
Generally, it takes about 5-10 minutes for a tablet to dissolve. However, other factors (eg, the moisture of your mouth) can effect that time. Drinking something before taking your medication is a good way to help the tablet dissolve more quickly.
11. If I forget to take my SUBOXONE for a day will I feel sick?
SUBOXONE works best when taken every 24 hours; however, it may last longer than 24 hours, so you may not get sick. If you miss your dose, try to take it as soon as possible, unless it is almost time for your next dose. If it is almost time for your next dose, just skip the dose you forgot, and take next dose as prescribed. Do not take two doses at once unless directed to do so by your physician.
In the future, the best way to help yourself remember to take your medication is to start taking it at the same time that you perform a routine, daily activity, such as when you get dressed in the morning. This way, the daily activity will start to serve as a reminder to take your SUBOXONE.
12. What happens if I still feel sick after taking SUBOXONE for a while?
There are some reasons why you may still feel sick. You may not be taking the medication correctly or the dose may not be right for you. It is important to tell your doctor or nurse if you still feel sick.
13. What happens if I take drugs and then take SUBOXONE?
You will probably feel very sick and experience what is called a "precipitated withdrawal." SUBOXONE competes with other opioids and will displace those opioid molecules from the receptors. Because SUBOXONE has less opioid effects than full agonist opioids, you will go into withdrawal and feel sick.
14. What happens if I take SUBOXONE and then take drugs?
As long as SUBOXONE is in your body, it will significantly reduce the effects of any other opioids used, because SUBOXONE will dominate the receptor sites and block other opioids from producing any effect.
15. What are the side effects of this medication?
Some of the most common side effects that patients experience are nausea, headache, constipation, and body aches and pains. However, most side effects seen with SUBOXONE appear during the first week or two of treatment, and then generally subside. If you are experiencing any side effects, be sure to talk about it with your doctor or nurse, as s/he can often treat those symptoms effectively until they abate on their own.
1. Why do I have to feel sick to start the medication for it to work best?
When you take your first dose of SUBOXONE, if you already have high levels of another opioid in your system, the SUBOXONE will compete with those opioid molecules and replace them at the receptor sites. Because SUBOXONE has milder opioid effects than full agonist opioids, you may go into a rapid opioid withdrawal and feel sick, a condition which is called "precipitated withdrawal."
By already being in mild to moderate withdrawal when you take your first dose of SUBOXONE, the medication will make you feel noticeably better, not worse.
2. How does SUBOXONE work?
SUBOXONE binds to the same receptors as other opioid drugs. It mimics the effects of other opioids by alleviating cravings and withdrawal symptoms. This allows you to address the psychosocial reasons behind your opioid use.
3. When will I start to feel better?
Most patients feel a measurable improvement by 30 minutes, with the full effects clearly noticeable after about 1 hour.
4. How long will SUBOXONE last?
After the first hour, many people say they feel pretty good for most of the day. Responses to SUBOXONE will vary based on factors such as tolerance and metabolism, so each patient’s dosing is individualized. Your doctor may increase your dose of SUBOXONE during the first week to help keep you from feeling sick.
5. Can I go to work right after my first dose?
SUBOXONE can cause drowsiness and slow reaction times. These responses are more likely over the first few weeks of treatment, when your dose is being adjusted. During this time, your ability to drive, operate machinery, and play sports may be affected. Some people do go to work right after their first SUBOXONE dose; however, many people prefer to take the first and possibly the second day off until they feel better.
If you are concerned about missing work, talk with your physician about possible ways to minimize the possibility of your taking time off (eg, scheduling your Induction on a Friday).
6. Is it important to take my medication at the same time each day?
In order to make sure that you do not get sick, it is important to take your medication at the same time every day.
7. If I have more than one tablet, do I need to take them together at the same time?
Yes and no—you do need to take your dose at one "sitting," but you do not necessarily need to fit all the tablets under your tongue simultaneously. Some people prefer to take their tablets this way because it’s faster, but this may not be what works best for you. The most important thing is to be sure to take the full daily dose you were prescribed, so that your body maintains constant levels of SUBOXONE.
SUBOXONE (buprenorphine HCl/naloxone HCl dihydrate)sublingual tablet
8. Why does SUBOXONE need to be placed under the tongue?
There are two large veins under your tongue (you can see them with a mirror). Placing the medication under your tongue allows SUBOXONE to be absorbed quickly and safely through these veins as the tablet dissolves. If you chew or swallow your medication, it will not be correctly absorbed as it is extensively metabolized by the liver. Similarly, if the medication is not allowed to dissolve completely, you won’t receive the full effect.
9. Why can’t I talk while the medication is dissolving under my tongue?
When you talk, you move your tongue, which lets the undissolved SUBOXONE "leak" out from underneath, thereby preventing it from being absorbed by the two veins. Entertaining yourself by reading or watching television while your medication dissolves can help the time to pass more quickly.
10. Why does it sometimes only take 5 minutes for SUBOXONE to dissolve and other times it takes much longer?
Generally, it takes about 5-10 minutes for a tablet to dissolve. However, other factors (eg, the moisture of your mouth) can effect that time. Drinking something before taking your medication is a good way to help the tablet dissolve more quickly.
11. If I forget to take my SUBOXONE for a day will I feel sick?
SUBOXONE works best when taken every 24 hours; however, it may last longer than 24 hours, so you may not get sick. If you miss your dose, try to take it as soon as possible, unless it is almost time for your next dose. If it is almost time for your next dose, just skip the dose you forgot, and take next dose as prescribed. Do not take two doses at once unless directed to do so by your physician.
In the future, the best way to help yourself remember to take your medication is to start taking it at the same time that you perform a routine, daily activity, such as when you get dressed in the morning. This way, the daily activity will start to serve as a reminder to take your SUBOXONE.
12. What happens if I still feel sick after taking SUBOXONE for a while?
There are some reasons why you may still feel sick. You may not be taking the medication correctly or the dose may not be right for you. It is important to tell your doctor or nurse if you still feel sick.
13. What happens if I take drugs and then take SUBOXONE?
You will probably feel very sick and experience what is called a "precipitated withdrawal." SUBOXONE competes with other opioids and will displace those opioid molecules from the receptors. Because SUBOXONE has less opioid effects than full agonist opioids, you will go into withdrawal and feel sick.
14. What happens if I take SUBOXONE and then take drugs?
As long as SUBOXONE is in your body, it will significantly reduce the effects of any other opioids used, because SUBOXONE will dominate the receptor sites and block other opioids from producing any effect.
15. What are the side effects of this medication?
Some of the most common side effects that patients experience are nausea, headache, constipation, and body aches and pains. However, most side effects seen with SUBOXONE appear during the first week or two of treatment, and then generally subside. If you are experiencing any side effects, be sure to talk about it with your doctor or nurse, as s/he can often treat those symptoms effectively until they abate on their own.
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