Questions & Answers

1. What is Narcotic dependence ?
   Narcotic dependence is a medical condition where the patient has been taking narcotic drugs (Opiates, Heroin, Methadone, or other painkillers) and the patient’s body has become physically dependent on these drugs. Drug dependence can happen as rapidly as 1-2 weeks after starting use since tolerance builds up rapidly. After tolerance is developed, if narcotics are not taken the patient will go through a very painful withdrawal. Usually withdrawal takes 5-10 days and is characterized by extreme discomfort and pain, diarrhea, sweats, sleeplessness, and abdominal cramps. Most people are unable to tolerate it without help.

2. What is Suboxone?
   Suboxone is a medication that has some opiate properties and therefore relieves withdrawal symptoms. It attaches to the endorphins or opiate receptors in the brain and stimulates them and is therefore like an antagonist, similar to the other opiates including Heroin, Methadone and Oxycontin. However, it also has some antagonist properties like Naltrexone. It seems to block the endorphin receptors and is there for termed a partial antagonist. Suboxone contains two medicines, Buprenorphine and also Narcan. The Narcan is our pure antagonist and is added to make sure that the drug is not used IV. One of the unique features of Suboxone is that it has an extremely long duration in the body. It takes a long time to wean off the brain receptors and therefore only needs to be given once a day and seems to provide a very stable blood level, avoiding the ups and downs of most other opiates.

3. Why is Suboxone used to treat Heroin and other opiates?
   The active ingredient in Buprinorphine, which is the active ingredient in Suboxone, has been available since 1982. In 2003, the Federal Government approved Suboxone as a treatment that could be given in doctor’s office after the doctor has completed some special training. The drug can be prescribed to help patients stay off street drugs.

4. How well does it work?
   Suboxone is a powerful opiate and it works very well. When patients take it on a regular basis it does fill most of the opiate receptors in the brain and therefore patients lose their cravings for other opiates including street drugs or Methadone. People report that they have very little cravings. They report very low incidents of mental effects or any other side effects.

5. Are there problems with Suboxone?
   Suboxone tends to have very few side effects that we are aware of.   One of its biggest downfalls is that it is an addictive drug and patient’s who have been on it for a period of time will have withdrawal as when they come off of it.  This withdrawal syndrome tends to be fairly mild but tends to last a long time.