Overcoming The Negative Connotation Of Suboxone Use In Treatment
"It's incredibly hard for me," says Justin (an alias used to protect confidentiality), a patient at Bicycle Health who was addicted to oxycodone for five years and is now on buprenorphine/naloxone (Suboxone) and in recovery for the past six months.
"I've been taking Suboxone every day, and I'm back to work and feeling a lot more in control—like I'm on the right track." My family, on the other hand, does not agree. They don't trust me anymore, and my pals believe I'm just trading one drug for another and that I need to work harder to truly get clean."
Justin isn't the only one who feels this way.
Patients suffering with opioid use disorder—addiction to medicines such as oxycodone, hydrocodone, fentanyl, and heroin—may find it difficult to admit they have a problem and seek help. When this is reinforced by well-intentioned friends and family members who care but don't understand addiction, a patient can feel isolated, unsupported, and doubtful of their recovery.
So, how can we help patients overcome stigma and support their long-term healing efforts? We want to dispel some prevalent myths about opioid addiction, buprenorphine/naloxone (Suboxone), and recovery in this post. We also offer tools and resources to assist patients, their families, and their friends.
The first myth is that addiction is a "curable" disorder.
While addiction was originally regarded to be a "curable" condition, we now know it is a chronic "bio-behavioral disorder," meaning it affects a person's physical, mental, and emotional health for the rest of their lives. We also know that people in recovery are more prone to experience relapse.
Dr. Brian Clear, Chief Medical Officer at Bicycle Health, adds, "We have significantly evolved our understanding of the brain disease of addiction." "Studies over the last several decades have shown that addiction is not a moral or willpower problem. Instead, it's similar to other chronic disorders like high blood pressure (hypertension), asthma, and diabetes, in which people go through periods of relapse and recovery, which is normal." Relapse rates in addiction are similar to those in other chronic disorders, as shown in this graph.
Misconception #2: "Can't I just go to detox and be done?"
Detoxification is merely the first step in the therapeutic process, and it is rarely enough to ensure long-term recovery. Detox is really discouraged by the American Society of Addiction Medicine (ASAM). What is the reason for this?
"When a person who is used to using opioids—such as percocets or fentanyl—goes through detox and then comes out, their brain's opioid receptors lose tolerance to opioids," Dr. Clear explains. If the individual relapses, the opioids in their brain overwhelm them, resulting in an overdose and even death."
That's why evidence-based opioid use disorder drugs like methadone, buprenorphine/naloxone (Suboxone), and naltrexone (sometimes known as vivitrol) are critical in rehabilitation. If someone gets detoxed without being put on one of these drugs, they have a 90% probability of relapsing within 60 days. When given medicine, however, 40-60% of patients will still be doing well a year after detox. In the end, solid scientific data suggests that these drugs are effective in preventing relapse, overdose, and death.
Misconception #3: But isn't Suboxone merely a substitution for another drug?
Suboxone (buprenorphine/naloxone) is an evidence-based treatment for opioid use disorder. As a partial-agonist, it binds to opioid receptors in the brain, partially activating them to prevent cravings and withdrawal while inhibiting oxycodone and fentanyl from reaching the brain.
It also has a ceiling effect, which means that even if a patient takes too much, they will not go "high" or overdose. As a result, it is regarded as both safe and effective.
"What I often ask my patients when they are afraid that buprenorphine is a replacement for another drug is, 'How do you feel after you take buprenorphine each morning?' says Dr. Clear. They usually say they're OK—not high, not sedated, simply fine. 'Then, before you take buprenorphine, how do you feel the next morning?" And the answer is the same: there is no hunger, no withdrawal, and everything is normal. That's not like how other people utilize opioids."
"I view buprenorphine like I see diabetes and high blood pressure medicine," he continues. It should be taken every day if it helps my patients get up and go to work, pay their bills, reconnect with their values, enjoy life, and take better care of themselves."
suboxone doctor Misconception #4 "However, I'll have to do this for the rest of my life." It's as though I'm wearing handcuffs!"
Patients' brains are biochemically rewired after they become addicted to opioids through numerous reward, memory, and mood pathways. As a result, rewiring these pathways takes time: It normally takes at least 6 months to begin the rewiring process, and at least 18 months for the pathways to return to normal.
Dr. Clear adds, "This is actually a marathon, not a sprint." "It takes years to rebuild a person's life—to develop habits like working, a support system of trusted family and friends, and good coping techniques."
"Treatment with Suboxone provides for the stability of opioid receptors, allowing patients to adopt lifestyle adjustments that lead to ultimate recovery rather than relapse cycles," he explains. Treatment techniques like as therapy, exercise, relaxation strategies, spiritual connections, sleep, proper nutrition, and overall self-care should be combined with medications so that when patients are stressed or have triggers, they can use healthy coping mechanisms and avoid recurrence."
Patients should be on pharmaceuticals like Buprenorphine "as long as they need to be," according to recent scientific advice, and there is no urgency to get them off.
More FAQs are available on the Provider Clinical Support Services (PCSS) website of the American Association of Addiction Psychiatry (AAAP). So, knowing what we know—that patients who aren't on opiate addiction medications have a high rate of relapse; that buprenorphine/naloxone (Suboxone) is a safe and effective treatment for opioid addiction; that it helps patients feel normal and allows the brain to rewire so they can go about their lives—how do we combat stigma and respond to family and friends who are still skeptical?
Some Pointers suboxone doctor
Inform individuals who are close to you about your recovery. Let them know you're on the mend and working hard every day to get back on your feet.
If they inquire about Suboxone, inform them that the medicine has a proven track record of success. Addiction treatment that focuses solely on abstinence does not work.
Remember, "this is a marathon, not a sprint," as Dr. Clear put it. Rather of feeling overwhelmed and pressed to get back on track and to the beliefs and lifestyle you choose, keep in mind that results do not come quickly. "One day at a time," or even "one hour at a time," can help you take a more realistic approach to rehabilitation.
Remember that regaining the trust of your friends and family may take some time. While it may be frustrating to be judged, you can take control by FOCUSING ON YOU and nourishing your recovery by doing things like getting into an exercise routine, seeing a therapist, attending 12-step meetings (such as AA/NA, Smart Recovery), getting a sponsor, eating healthy, sleeping well, seeing your doctor, and taking care of yourself. It's fine to put yourself first! That is the point of recuperation. It must be a continuous effort! Though it may take some time, your actions will eventually show others how far you have progressed. But that isn't why you're doing it; keep loyal to yourself and the outcomes will speak for themselves.
Help others understand that addiction is a chronic, lifelong brain disease, that relapse is common and is a normal part of recovery, that treatment should be continuous, and that you need their support to fully embrace recovery.