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Answers to Common Questions
“Getting sober was one of the three pivotal events in my life, along with becoming an actor and having a child. Of the three, finding my sobriety was the hardest thing.”
- Robert Downey Jr
Q: What Is Opiate Use Disorder?
Opioid use disorder is defined as a problematic pattern of opioid use that leads to serious impairment or distress. This can be use of prescription opioids like Oxycodone or illicit opioids like heroin. Nerve cells in the brain are outfitted with opioid receptors — think of them as tiny docking stations. These receptors draw in the body’s natural opioids, such as the endorphins released during exercise or sex, as well as manufactured opioids, such as heroin, oxycodone, and hydrocodone. When opioids bind to these receptors, this triggers a surge of dopamine. Dopamine is a chemical involved in the brain’s pleasure and reward system. When heroin is shot up or Oxy pills taken, the surge of dopamine becomes a flood. And when your brain is flooded with dopamine day after day, year after year, circuits go awry. The brain then needs more and more opioids, developing extra opioid receptors to accommodate the daily deluge. Then when you don’t do that shot of heroin, you have all of these opioid receptors that are screaming for their opioids. That is what causes withdrawal.
Q: How do you treat Opiate Use Disorder?
Pavana Treatment Group uses FDA-approved medications to treat opioid use disorder (OUD). Medication-assisted treatment is considered to be the gold standard for OUD. Medications used for the treatment of OUD include buprenorphine (Suboxone®, Subutex®), and naltrexone (Vivitrol®). We also encourage and refer our patients to seek behavioral health services, such as counseling or group therapy.
Q: What is Suboxone?
Suboxone combines two drugs: buprenorphine and naloxone (commonly known as Narcan). Buprenorphine, the dominant component, suppresses withdrawal and cravings, while naloxone stops patients from abusing the medication. Here’s a more detailed explanation of the unique way Suboxone works on the brain, offering relief from addiction and the promise of a fresh start.
Q: How does Suboxone Work?
Suboxone combines buprenorphine with a low naloxone dose in a film that slowly melts under the tongue. Buprenorphine is classified as a partial agonist which is a weak opioid. Buprenorphine molecules fill those screaming opioid receptors so they stop screaming, without triggering a high. Most people taking buprenorphine report that they just feel normal or more energized. Taking more buprenorphine than the prescribed amount does not produce more pleasure. Nothing happens because the receptors are already full from the buprenorphine. When you take buprenorphine daily, as instructed, it lasts 24 hours. Therefore your opioid receptors are continually filled and you avoid withdrawal. Naloxone is an antagonist / opioid blocking medication that causes withdrawals if someone tries to inject or snort the Suboxone®. The low dose of naloxone in Buprenorphine, taken as a film, results in very little is absorbed into the bloodstream so it won’t trigger withdrawal when taken properly.
Q: What happens if i Relapse and take other Opioids while on suboxone?
Suboxone still rescues you in that regard as well because it blocks most other opioids (heroin, Vicodin, oxycodone) from locking into the receptors and so you won’t get high. Nothing happens because the receptors are already full from the buprenorphine. When you take buprenorphine daily, as instructed, it lasts 24 hours. Therefore your opioid receptors are continually filled. If you take an opioid while on Suboxone the naloxone may cause immediate withdrawal symptoms which is a very unappealing side effect. Rather than sink back into addiction, you’ve now got time to evaluate your actions. What you choose to do with this time will determine your long-term success.
Q: is mAT just replacing one drug with another?
No, it is not. Opiate addiction is a chronic disease and MAT utilizes medication to treat this chronic disease just like a diabetic is dependent on insulin. A common misconception associated with MAT is that it substitutes one drug for another. Instead, these medications relieve the withdrawal symptoms and psychological cravings that cause chemical imbalances in the body. MAT programs provide a safe and controlled level of medication to overcome the use of an abused opioid. Research has shown medications used in MAT, prescribed at the proper dosage, have no adverse effects on a person’s intelligence, mental capability, physical functioning, or employability. Unlike people who are addicted to opioids or other substances, people who are dependent on buprenorphine lead normal lives; take care of their families, maintain friendships, excel at their jobs, go back to school, and pay their bills.
Q: When Can i Get off suboxone?
The most common question asked by new patients in treatment is “How soon can I get off Suboxone?” The honest answer for most patients is “not soon”. Most people that come off of it before their brain is ready are going to relapse. Every person is different, but as a general rule, if you were addicted to pills for five years, you can probably taper off Suboxone in five years. On the other hand, if you’ve been using opioids for decades, you will likely need Suboxone for the rest of your life. Most patients can safely reduce their Suboxone dose within a few months and then settle on a low maintenance level. This is because the brain gradually sheds the extra receptors it had developed in response to the daily dopamine flood. The brain actually reabsorbs the receptors because it does not need them. Once that occurs then you don’t need the dose you were taking before. But if you quit Suboxone before your brain has shed all the extra receptors and has otherwise been restored, you’re likely to relapse. OUD is a chronic disease of brain chemistry where your brain has been rewired in a way that not only warps your judgment and self-control, but also leaves you to prone to relapse at the slightest reminder of opioids. When you are taking Suboxone properly and at the right dose, your opioid receptors are continually filled and therefore you’re far better equipped to walk away from any triggers or memories of using.
Q: What is Narcan?
You may know that Narcan is the drug injected to reverse opioid overdoses and save lives. Taken this way, Narcan instantly boots opioids off the receptors, restoring breathing while sending the person who overdosed into severe withdrawal.