Dr James Schaller
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Suboxone Basic Information

What is This Medication Used For?

Suboxone is used for opiate dependence. The dependence can be to heroin, methadone, oxycodone or any of the common medicines that hit the opioid or pain receptors. The active chemical is buprenorphine. If you take this medication, you should not have any withdrawal symptoms from these opioids, and it is meant to replace them. It is a legal medication and has some special abilities that make it more functional to take instead of these other options.

What is Subutex?

Subutex is pure buprenorphine. I have been told it is possible to overdose on this medication and literally die. So there has been developed a better product that prevents abuse -- Suboxone. It has naloxone, so if injected you are less likely to die from high doses. Also, some doctor's use Subutex in your first days or first week of treatment, and others start right with Suboxone.

Why Should I Care About Suboxone? What is the Big Deal?

If you are on methadone replacement, you have to go to a limited number of licensed centers almost every day. This is hard to do if you are trying to go to school or work or raise a child.

If you are addicted to opioids like Dilaudid, percocet, oxycodone or Oxycontin, and are not using them as prescribed under a single physician's care, you might be tempted to do things that are illegal. You might get your insurance company or the authorities to start looking at you. Many doctors are getting in trouble and some are going to prison for reasonable chronic pain control, so do not assume the authorities will be casual with you.

Any Risks or Side Effects with Suboxone?

* In Europe there have been reports that injected benzodiazapines can be dangerous in combination. Also, oral benzodiazapines like Ativan, Klonopin and Xanax should likely be used carefully. The concern is likely that a person who is not used to higher doses of an opioid, has a risk for breathing trouble if too many respiratory relaxants.

* The liver metabolizes this medication. You might consider nutrients that might help the liver like NAC, which is used in ER's for years for certain drug overdoses to help the liver. See my liver articles on this web site.

Some folks report these and many other side effects. This is a mere sample:

  • Nausea
  • Sweating
  • Headaches
  • Cold or flu-like symptoms
  • Sleeping difficulties
  • Mood lability
  • Irritability

Do I Have to Go To a Center for Suboxone?

After the first week of treatment, most practitioners will know the dose you need to feel comfortable. And eventually you will be given larger supplies, likely ending up with a month supply. So you can do other things besides sit around a clinic waiting for methadone or trying to get more of a prescription opioid.

Can My Family Doctor Prescribe this Medication?

Only physicians who have completed a special education course can prescribe it. At the time of this abstract, there were 6500 physicians who were approved by the DEA with a special second DEA number to write for Suboxone.

How Do You Take It?

It comes in two sublingual tablets, which are put under your tongue. You do not swallow it. The sizes are 8 mg and 2 mg.

Who Has It?

Any local pharmacy should have it or can order it in. Do not assume it is sitting on the local pharmacy shelf and suddenly detox yourself before you have it in your hand.

It is usually packaged in 30 tablet units to your pharmacist, and might involve a little special paperwork. So treat the pharmacists and their assistants nice, and never act in a manner that makes you look impaired or like an addict, with pharmacy staff. They may find a way to stop getting this medication in. Some pharmacists treat this medication like heroin, and are poorly educated about it. But it is a good medication for folks wanting to improve their life! If you are gracious and friendly, it will go a long way to making sure you and others will be able to get access to this medication in the future.

Why Did They Add Naloxone?

Naloxone blocks excess buprenorphine effects. It is an opiate antagonist -- it prevents opioid effects. It has been added to prevent overdose effects and to prevent intravenous abuse of buprenorphine.

Is This Experimental or is Suboxone FDA Approved?

Subutex and Suboxone have been studied in thousands of pateints. I have the impression that at least 2,000 patients were researched before the medication had FDA approval in 2002.

If each doctor who is allowed to prescribe it has prescribed it for five pateints, that is 6500 times 5 or 32,500 patients. We are allowed to treat 30 patients at a time with our special Suboxone DEA certificate, and some want this number increased.

Am I Just Going to Take Another Addictive Medication?

I do not believe so. First, this medication has an opioid, buprenorphine, with unique properties that appear to make it less addictive.

Also, Suboxone is a schedule III medication under the Controlled Substances Act, so it is considered to have less risk for causing psychological and or physical dependence than Schedule II meds like morphine, oxycodone, fentanyl, or methadone. Schedule III medications can be called into the pharmacy. You do not need a paper script for Suboxone, so your physician can call it in. I would come with your pharmacy number so your certified physician can call the Suboxone in. During the call, you and your physician will learn if it is in stock, and if it needs to be ordered, how long will be your wait.

Best Regards!

Dr. J

Bank Towers, Tamiami Trail, Naples, FL
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