How Long Should You Stay On Suboxone?
The use of Suboxone to treat heroin addiction has been a hot and highly controversial topic recently. One side argues that opioid-replacement therapy saves lives, as it is more difficult to abuse or overdose on drugs like Suboxone than on heroin, fentanyl and other forms of opioids. Proponents also say Suboxone use allows those with opioid addiction to live normal lives and become functional.
Opponents argue that Suboxone is more addictive than heroin and other forms of opioids, and that replacing opioid use with Suboxone is simply trading one addiction for another. Some also say 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 it.
Family First Intervention’s opinion on this matter is very simple: True recovery from opioid addiction is being completely off opioids in any form. However, simply stopping the use of opioids cold turkey is dangerous to the individual, and it is often necessary to taper off the drugs slowly – via medical detox.
Furthermore, Family First Intervention recognizes that Suboxone (aka buprenorphine) and other drugs used in medical tapers AND in maintenance therapy can be more addictive than the opioid the individual first became addicted to – such as heroin, oxycontin or other prescription painkillers. This is why any use of Suboxone should be carefully monitored by a trusted team, and the use of the drug should be only with the intent of tapering down the dose and until the person is on no drugs whatsoever.
For better or worse, the FDA only allows medical professionals to prescribe certain approved drugs – such as Suboxone – during heroin and prescription painkiller detox. For instance, 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 that there have been many reckless practices regarding the use of Suboxone in certain clinics and so-called “recovery programs.” Some heroin addiction treatment programs have started patients on extremely high doses of Suboxone and/or methadone. These programs have been known to give patients as much as 14 to 16 milligrams of buprenorphine or 150 to 300 milligrams of methadone when, in actuality, much lower doses would suffice.
Is Suboxone Therapy Right for Me?
As for opioid maintenance programs, we believe that Suboxone use may be the best option for some – but certainly not all – heroin addiction cases. Opioid maintenance programs that involve long-term use of Suboxone or methadone should be reserved only for the harm-reduction properties they are renowned for.
People who have had chronic relapses and IV drug users are examples of high-risk individuals who could benefit from opioid maintenance, since the threat of overdose and death without this therapy is very high.
Suboxone for Heroin and Painkiller Detox
Detox and tapering off opioid addiction are where the real benefits of Suboxone come into play. As mentioned earlier, the long-term use of Suboxone can either 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 administer and then set up a taper schedule, which slowly decreases the dose until the patient is completely off the drug.
What families need to look out for – especially with specious Suboxone clinics – is if the clinic or program pushes abnormally high doses of Suboxone or methadone. Families should also look into whether 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 painkillers know if the replacement doses are too high? Likewise, even heroin user themselves may not understand the conversion and comparison rates between heroin and Suboxone.
This is why we feel it is important to have a neutral party offering help to the families of heroin addicts. This outside party needs to look out for the family’s best interests, including the safety and wellness of the addicted loved one.
Long-Term Addiction to Suboxone or Methadone
While it is best to try to avoid any long-term use of opioid-replacement drugs, there are many patients who are already taking high doses of Suboxone and methadone and who 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 it is with heroin addiction: Start a detox plan that aims to taper down the dose in a safe manner until you are not taking any medication at all and can sustain your sobriety.
Detoxing from Suboxone may have a different timeline for recovery than with heroin addiction recovery. So, it is best to start off with an opioid addiction assessment that takes into account:
- How long you have been on Suboxone or methadone
- How high the doses were
- What type of opioid taper schedule will be safe and effective for you based on your risk factors
Finding Reliable Methadone or Suboxone Detoxification
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 doses of buprenorphine or other opioid-replacement medications.
For example, many detox centers will not admit an individual if he or she is taking more than 80 milligrams of methadone, or more than 16 milligrams of buprenorphine. 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 may feel disheartened or disappointed after a rejection from a drug rehab program because of the high-dose consumption, but they should not give up hope. There is still an opportunity to make a full recovery and to not have to spend the rest of one’s life on opioid drugs. It just requires extending the time frame 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 a realistic recovery time frame. The biggest thing we want to stress to families is that there is always a clear path to recovery, even in the most extreme cases of opioid addiction.