Are people on Suboxone sober? With the opioid epidemic raging, the battle against heroin and opiate addiction continues to increase. The number of people entering treatment for opioid dependency continues to rise. The way the addiction industry, doctors, psychiatrists, and detoxes treat opioid addiction has shifted in the last decade.
The trend is leaning towards Medication-Assisted Treatment, specifically replacement therapy. Methadone, which has been around for decades, has been controversial in its effectiveness. Studies and results focusing on the long-term results of Methadone on abstinence from other opioids have varied. Arguments exists as well about whether Methadone can be abused or used to “get high”.
Two Sides to the Issue
This posts deals specifically about Buprenorphine, commonly prescribed as Suboxone or Subutex, and the questions it raises about medication and sobriety. As with most ‘controversial’ topics, there are two sides to the issue. First I will explain the stringent or sobriety purists view on people taking Suboxone. There are indeed people and members of 12 step groups who will claim that people on medication-assisted treatment, such as Buprenorphine are not sober. This has caused tension between addiction specialists, chronic pain patients, and recovery programs. Here is why some may believe that people taking Suboxone or Subutex are not actually sober.
(Caution: These are not my own, nor NewBridge Recovery’s, personal opinions, and the views presented here are gathered from various outside sources) In the strictest sense of the word, sobriety is the continued absence of any psychoactive drug usage. Now Buprenorphine or Suboxone is a narcotic drug, as recognized by the medical and health community. It is a controlled substance and has a “high risk for addiction and dependence”. To be more specific, it is a partial opioid agonist, which means it affects the brain in many of the same ways that other narcotic opioids like hydrocodone and heroin do.
Medications Can Lead to Mental and Physical Dependency
While many people claim it is impossible to get high off of Buprenorphine, again there are discrepancies. From people who have used Suboxone to get off heroin or painkillers, they describe a “light to mild opioid buzz the first week or so, which eventually the brain becomes accustomed to”. Stories exists of people abusing their doses or even snorting or using IV methods to get high on Buprenorphine, but it appears that when used correctly, the “high” from Suboxone is minimal and diminishes with time. In fact, Suboxone contains Naloxone, which blocks the effects of opioid medication, including pain relief or feelings of well-being that can lead to opioid abuse.
Are Suboxone Patients Sober?
The overall consensus seems to be that patients who are taking Buprenorphine as prescribed by a doctor are indeed in recovery from addiction, and should be considered sober. The problems arise when heroin addicts, for example, come out of detox using Suboxone, go to 12 step meetings, and are told they are not sober because they are taking “mind or mood altering chemicals”. If we institute this strict standard, then are people who drink coffee (caffeine), smoke cigarettes (nicotine), and take anti-depressants sober? These are all mood altering drugs and chemicals, albeit legal ones.
Are People Who Take Suboxone Sober?
This can send mixed messages to the recovering addict and actually damage sobriety and lead to relapse. It should also be noted that Buprenorphine and Suboxone are not meant to be used as a long-term treatment and should follow a slow medically supervised tapering off of the drug. The exceptions to
this are people with chronic pain who cannot function without some form of narcotic pain medication. Even in these cases, Suboxone can be a great alternative to the more addictive opioid medications like hydrocodone, oxycodone, and fentanyl.
Thoughts to Ponder
So what are the benefits of putting down someone’s recovery who utilizes medical assistance to get off of deadly narcotics? Evidence proves that Buprenorphine reduces overdose deaths and increases effectiveness in the treatment of opioid addiction. If a newly sober person on Suboxone walks into a recovery meeting, only to be told they are not sober, what are there chances of returning or seeking community support? A expert in the addiction field explained it better than I can:
“In someone gets cancer, we prescribe them chemotherapy to fight their disease. These radiation treatments may last months until complete remission has happened. Essentially, the same thing occurs with opioid addiction. Medication-Assisted Treatment, like Suboxone, is their chemotherapy. It rids their brain of the craving and obsession to return to illegal or narcotic drug usage until they are stable enough to enter ‘remission’. In fact, most Suboxone prescribers require 12 step attendance or some form of therapy in accordance with medication to prepare the person for their post-addiction life” – Martin Seligman PhD
Originally Posted Here