About Suboxone Treatment

Dr. Pradeep Kumar has been trained and licensed in OBOT (Office-Based Opioid Treatment) and has continued to serve individuals and their families affected by addiction since 2005 with Suboxone, Subutex and individual psychotherapy and family support. Dr. Kumar treat addiction as a chronic disease that requires extensive management and support. Pain medicine, heroin and methadone dependence is often complicated by other medical, psychological, and situational conditions.

It is crucial to treat all aspects of this disorder with psychotherapy, medical management, and ongoing supports are necessary for recovery and remission. Office based Suboxone and Subutex treatment in Dallas area continues to excel in addiction and mental health treatment, while serving those affected by this illness by promoting lasting recovery. Many people avoid seeking treatment because of the stigma, fear, shame, and anxiety.

At Brain & Behavior Center (DBA Plano Behavioral Health), we have always emphasized upon helping our patients with wide array of treatment relater to addiction. We bring to our patients, Suboxone® Treatment, Subutex® Treatment, Heroin Addiction Treatment, Buprenorphine Treatment, Opiate Addiction Treatment, Oxycodone Addiction Treatment and Percocet Treatment. Our forte lies in bringing our patience holistic treatment, not just for the recovery, but also after treatment care to makes sure they do not become victims of relapse.

Opioid Dependence & treatment questions

How Common is Opioid Dependence?

Opioid dependence is more common than you may think. Opioid dependence is not predictable it is a reaction that occurs in people who, for reasons that are not completely understood, are biologically and psychosocially vulnerable. Men and women of all ages, races, ethnic groups, and educational levels can become dependent on opioids.

How Common is Misuse of Opioid Pain Relievers?

According to the 2003 National Survey on Drug Use and Health: 4.7 million people ages 12 and older misused pain relievers in 2003.

In 2001, almost 2.5 million people used pain relievers non-medically (ie, for recreational purposes) for the first time. This is a 335% increase from 1990, when 573,000 reported using pain relievers non-medically

Misuse of Pain Relievers Increased Dramatically From 1970 to 20011

Taken from NSDUH chart re: number of new users of pain relievers for nonmedical purposes among people ages 12 and older.

How Common is Heroin Use?

As of 2003, roughly 3.7 million Americans ages 12 and older reported having tried heroin at least once in their lives. More than 400,000 people reported that they had used heroin within the last year.

Over the last 2 decades, inexpensive, high-purity heroin has become more available. Rather than injecting, many new users are smoking or snorting heroin, with the misperception that these routes are less addictive. Also, use is growing among younger adults and in many suburban communities.

Why Are Some People More Likely to Become Opioid-Dependent?

Exactly why some people, and not others, become dependent on opioids (or any addictive substance) is not totally understood. Most people who take opioids do not become opioid-dependent. However, certain factors appear to increase the likelihood of dependence, including:

  • Risk-taking or novelty-seeking personality.
  • Psychiatric disorders (eg, depression, bipolar disorder).
  • Stress (high stress seems to increase the desire to use drugs).
  • Properties of the drug itself (eg, how quickly it creates a "high," how long the effects of the drug last).
  • Genetic factors that influence drug metabolism.
  • Genetic factors contributing to the risk of addiction (ie, a family history of alcoholism)
  • Lastly, substance abuse, which can lead to dependence, is often highly influenced by societal norms and peer pressure.

How long has Suboxone been used to treat opioid dependence?

All opioids can cause physical dependence. Suboxone belongs to a class of opioids called partial opioid agonists. As a partial agonist, buprenorphine appears to produce less physical dependence, limited euphoria, and less potential for abuse compared with a full agonist, eg, heroin, oxycodone, and hydrocodone. Suboxone has potential for abuse and produces dependence of the opioid type with a milder withdrawal syndrome than full agonists.

When patients are ready to stop taking Suboxone?

the dose is slowly and gradually tapered. The withdrawal symptoms of Suboxone are milder than those seen with a full opioid agonist and can be managed with your doctor's supervision.

Can I take too much Suboxone?

Taken on its own, Suboxone has lower potential for fatal overdose than a full opioid agonist because it has a limited effect on reducing breathing. Taking more Suboxone does not affect breathing as much as full opioid agonists can, so it is less likely to cause death in cases of accidental or deliberate overdose when taken in the absence of benzodiazepines, sedatives, tranquilizers, antidepressants, or alcohol. Intravenous misuse of buprenorphine, usually in combination with benzodiazepines or other central nervous system (CNS) depressants, has been associated with significant respiratory depression and death.

SUBOXONE® (buprenorphine HCl/naloxone HCl dihydrate)sublingual tablet

Can I switch from methadone to Suboxone?

It is possible to switch to Suboxone from methadone treatment, but because everyone's situation is different, switching should first be discussed with your doctor.

How long will I stay on Suboxone?

The length of your Suboxone treatment depends on what your doctor, you, and, possibly, your counselor or therapist decide is best for your needs. Although short-term treatment may be an effective option for some, for others it may not allow enough time to address the psychological and behavioral aspects of their condition. The chance of relapsing can be higher with short-term treatment because patients have less time to learn the skills needed to maintain an opioid-free lifestyle.

In general, suppressing cravings with Suboxone (for as long as necessary), together with counseling, offers the best likelihood for treatment success.

Discontinuing Suboxone abruptly can cause withdrawal symptoms, so when you are ready, your doctor will gradually taper your Suboxone dose. You should be aware of signs of relapse or withdrawal symptoms. Discard any leftover pills to ensure that they aren't used by anyone else.

Important directions about Suboxone use

Intravenous misuse of buprenorphine, usually in combination with benzodiazepines or other CNS depressants (including alcohol) has been associated with significant respiratory depression and death.

Suboxone combined with medications/drugs

It can be dangerous to mix Suboxone with drugs like benzodiazepines, alcohol, sleeping pills and other tranquilizers, certain antidepressants, or other opioid medications, especially when not under the care of a doctor or in doses different from those prescribed by your doctor. Mixing these drugs can lead to drowsiness, sedation, unconsciousness, and death, especially if injected. It is important to let your doctor know about all medications and substances you are taking. Your doctor can provide guidance if any of these medications are prescribed for the treatment of other medical conditions you may have.

Potential for dependence

Suboxone and SUBUTEX® CIII (buprenorphine HCL sublingual tablets) have potential for abuse and produce dependence of the opioid type with a milder withdrawal syndrome than that of full agonists.

Contact your doctor if

  • You feel faint, dizzy, confused, or have any other unusual symptoms, or if your breathing becomes much slower than normal. These can be signs of taking too much Suboxone or of other serious problems.
  • You experience an allergic reaction. Symptoms of a bad allergic reaction include difficulty breathing, hives, swelling of your face, asthma (wheezing), or shock (loss of blood pressure and consciousness)
  • You suspect liver problems due to any of these symptoms:
    • 1. Your skin or the white part of your eyes turns yellow (jaundice)
    • 2. Your urine turns dark
    • 3. Your bowel movements (stools) turn light in color
    • 4. You don't feel like eating much food for several days or longer
    • 5. You feel sick to your stomach (nauseated)
    • 6. You have lower-stomach pain
  • Cytolytic hepatitis and hepatitis with jaundice have been observed in the addicted population receiving buprenorphine.
  • Your doctor may do blood tests while you are taking Suboxone to ensure that your liver is okay.
  • You've recently experienced a head injury (Suboxone can alter pupil size and cause changes in the level of consciousness that may interfere with patient evaluation)

Pregnancy

There are no adequate and well-controlled studies of Suboxone (a Category C medication) in pregnancy. Suboxone should not be taken during pregnancy unless your doctor determines that the potential benefit to you justifies the potential risk to your unborn child. Contraception should be used while taking Suboxone. If you are considering becoming pregnant or do become pregnant while taking Suboxone, consult your doctor immediately.

Many women also have changes in menstruation when they use opioids. This may continue while you are taking Suboxone. It is important to remember that you can still become pregnant even with irregular periods.

Breast-feeding

Buprenorphine will pass through a mother's milk and may harm the baby, so Suboxone is not recommended if you are breast-feeding. Your doctor should know if you are breast-feeding before you start treatment for opioid dependence.

Driving and operating machinery

Suboxone can cause drowsiness and slow reaction times. This may occur more often in the first few weeks of treatment, when your dose is being changed, but can also occur if you drink alcohol or take other sedative drugs when you are taking Suboxone. Caution should be exercised when driving cars or operating machinery.

Commonly reported side effects

Side effects of Suboxone are similar to those of other opioids. The most commonly reported adverse events with Suboxone include: headache (36%, placebo 22%), withdrawal syndrome (25%, placebo 37%), pain (22%, placebo 19%), insomnia (14%, placebo 16%), nausea (15%, placebo 11%), and constipation (12%, placebo 3%). Please see full Product Information for a complete list. You may already be experiencing some of these side effects because of your current use of opioids. If so, let your doctor know. Your doctor can effectively treat many of these symptoms.

Suboxone can cause blood pressure to drop. This can cause you to feel dizzy if you get up too fast from sitting or lying down.

Your doctor will determine if you need to stop taking Suboxone because of side effects.

Suboxone use in children

Suboxone can be used in people ages 16 and older. It hasn't been approved for use in children younger than 16. Accidental overdose in children is dangerous and can result in death. Always store buprenorphine-containing medications safely and out of the reach and sight of children. Destroy any unused medication appropriately.

Appropriate use of Suboxone

Do not use Suboxone or SUBUTEX for conditions for which they were not prescribed. Patients with a clinical need for analgesia should not be transferred to a Suboxone regimen. Suboxone is not indicated for pain management.

How do I Dispose of Unused Medicine?

According to the Food and Drug Administration (FDA) most drugs can be thrown in the household trash, but consumers should take certain precautions before tossing them out. A few drugs should be flushed down the toilet. And a growing number of community-based "take-back" programs offer another safe disposal alternative. Please visit the Food and Drug Administration website to find out more on how to dispose of your unused medicine