First off, make the case that suboxone, methadone, and other medications can save lives if used to ween people from opioid use disorders and dependency. But it is not the belief of Family First Intervention that opioid maintenance therapy and long-term use of opioid replacement drugs is a true recovery from addiction.
How Long Should You Stay On Suboxone?
This has been a hot and highly controversial topic recently, with one side arguing that opioid replacement therapy saves lives (as it is more difficult to abuse or overdose from drugs like suboxone than heroin, fentanyl and other forms of opioids) and allows those with opioid addiction to live normal lives and become functional. The other side of the argument states that suboxone is more addictive than heroin and other forms of opioids, that replacing opioid use with suboxone is simply trading one addiction for another, and that suboxone maintenance therapy is a reckless practice that gets individuals so dependent on the drug, that they may never be able to get off suboxone.
Family First Intervention’s opinion on this matter is very simple: true recovery from opioid addiction is being completely off of opioids of any form. However, simply stopping the use of opioids cold turkey is dangerous to the individual, and it is necessary to taper off the drugs slowly – via a medical detox.
Furthermore, Family First Intervention recognizes the fact that suboxone and other drugs used in medical tapers AND in maintenance therapy can be more addictive than opioids the addicted individual may be using – such as heroin, oxycontin, or other prescription opioid drugs. This is why any use of Suboxone should be carefully monitored by a trusted individual, and the use of the drugs should be only with the intent of tapering down dosages and eventually using no drugs whatsoever. Unfortunately, the FDA only allows certain approved drugs – like suboxone – to be used during cessation and detox from heroin and prescription painkillers, and no heroin rehab program in the United States is allowed to detox and taper a heroin-dependent person with heroin.
Is Suboxone for Opioid Use Disorder Safe?
Family First Intervention also recognizes the fact that there have been many reckless practices with the use of suboxone in certain clinics and so-called “recovery programs” – where some heroin addiction treatment programs have started patients on extremely high dosages of suboxone and methadone. These programs may be giving patients upwards of 14-16 mg of buprenorphine or 150-300 mg of methadone when they could be comfortably treated at much lower dosages.
Is Suboxone Therapy Right For Me?
As for opioid maintenance programs, we believe that this may be the best options for some – but certainly not all – heroin addiction cases. Opioid maintenance programs that involve long-term use of suboxone or methadone should be reserved for the harm reduction methods they were intended for. Those who have had chronic relapses and IV drug users may be examples of high-risk individuals that could benefit from opioid maintenance, whereas the threat of overdose and death without the therapy is very high.
Suboxone For Medical Heroin and Painkiller Detox
Detox and tapering from opioid addiction are where the real benefits of suboxone come into play. We have already shown how long-term use of suboxone can be beneficial or detrimental to a loved one’s recovery – depending on many factors. When it comes to the emergency service of detoxing a person from drugs when they have an opioid dependency, suboxone can be very helpful. Following an initial assessment, a reputable heroin detox program will gauge the correct amount of suboxone to be used, and set up a taper schedule (which slowly decreases the dosages until the patient is completely off the drug).
What families need to look out for – especially from disreputable suboxone clinics – is if the clinic or program pushes an abnormally high dosage of suboxone or methadone, or if the clinic pushes opioid maintenance therapy over medication-assisted detox with the goal of complete cessation. But how would a family member that doesn’t know much about heroin or painkiller dosages know if the replacement dosages are too high? Likewise, even the heroin user themselves may not understand the conversion and compare rates between heroin and suboxone. This is why we feel it is important to have a neutral party offering help for the families of heroin addicts. Someone who is looking out for the best interests of the family, and cares for the safety and wellness of the person who is addicted.
Long-Term Addiction to Suboxone or Methadone [H2]
While it is best to try and avoid any long-term use of opioid replacement drugs, there are many who are already taking high dosages suboxone and methadone that are ready to get clean for good. So what is the best way to stop the use of suboxone? The best treatment for Suboxone addiction is the same as with heroin addiction. To start a detox plan that aims to taper down the dosages in a safe manner until you are not taking any medication at all, and can sustain your sobriety.
Detoxing from suboxone may have different timelines for recovery than with heroin addiction recovery, and it is best to start off with an opioid addiction assessment that looks at how long you have been on suboxone or methadone, what the dosages taken are, and what type of opioid taper schedule will be safe and effective for you based off your risk factors.
Finding a High Dosage Suboxone and Methadone Detox
Making matters even more complicated, not all addiction treatment centers, opioid rehabs, and detox programs will accept you or a loved one if you are taking high dosages of buprenorphine or other opioid replacement medications. Many detox centers will not accept an individual as a patient if they are taking over 80 mgs of methadone, or over 16 mg of buprenorphine (Suboxone, Subutex, etc.). In these instances, it may be necessary to begin a long-term taper to reach a “stable” condition before setting a schedule for the eventual taper to zero.
Individuals and families can feel disheartened or disappointed to be rejected from a drug rehab program or facility because of the high dosages, but you cannot give up hope. There is still an opportunity to make a full recovery and not have to spend the rest of your life on opioid drugs. It just requires extending the timeframe of recovery and focusing on long-term treatment for addiction. Working with an addiction case management team can help the whole family establish and stick to a set of goals and recovery timeframe.
The biggest thing that we want to stress to families is that there is always a clear path to recovery, even with the most extreme cases of opioid addiction, and the many challenges that are ahead of you.