Suboxone

What is Suboxone®?

Suboxone® is a medication that contains buprenorphine and naloxone. It can help you with withdrawal symptoms you might have while you stop using opioids like heroin.

Suboxone® contains buprenorphine, which is a replacement for heroin or other opioids. It can help you to withdraw from opioids you’ve become dependent on by reducing cravings and limiting your withdrawal symptoms.

When you stop taking an opiate, you might have withdrawal symptoms as your body returns to normal. They can include: sweating; feeling hot and cold; runny eyes and nose; yawning; losing your appetite; stomach cramps; feeling sick or vomiting; diarrhoea; tremors; poor sleep; restlessness; general aches and pains; and just feeling awful.

Withdrawal symptoms usually get a bit better within 5 days, but you might still notice cravings for opioids, tiredness and restless sleep for a while afterwards.

How is Suboxone® prescribed?

One of our recovery workers and someone from our clinical team will give you a full health and wellbeing assessment. If the assessment shows that Suboxone® could be good for you, we’ll prescribe it. If you’ve ever injected drugs, we’ll help you to get a liver test, screening for any blood-borne viruses, and vaccinations that you might need.

Why choose Suboxone®?

Your prescriber will only give you Suboxone® if they think buprenorphine and naloxone together would be the best combination for you. In most cases, the prescriber will give you buprenorphine on its own.

Buprenorphine is not the only opioid substitute you can be prescribed. There is also a medication called methadone prescribed for opioid dependence.

• Some people feel more ‘clear-headed’ with Suboxone® than with methadone.

• Some people have difficulties using methadone.

• Suboxone® (which contains buprenorphine) tends to be easier to detox from than methadone. Some people take methadone long-term to maintain abstinence from heroin use but switch to Suboxone® or buprenorphine if they decide to detox.

• Suboxone® is less dangerous than methadone if you take an overdose.

Taking Suboxone®

Suboxone® comes as a ‘sublingual’ tablet, which means the tablet should be placed under the tongue and kept there until fully dissolved. This normally takes 5 – 10 minutes. Buprenorphine is absorbed straight into your bloodstream. The tablets do not work if you swallow them.

Usually, you’ll take buprenorphine once a day. At the start of treatment, the pharmacist who gives you your buprenorphine will need to be there when you take it. This is to make sure you’re taking the right dose for the buprenorphine to be safe and effective.

When you first take Suboxone®:

• If you use heroin you should wait at least6-8 hours after your last heroin dose.

• If you are taking methadone, your worker and prescriber will reduce your methadone dose before you begin taking Suboxone® . Then, you’ll take your first dose of Suboxone® between 24 and 36 hours after your last dose of methadone.

For Suboxone® to work well you need to take it when your body has low levels of heroin or methadone. You should only take your first dose when you feel some withdrawal symptoms starting. Suboxone® can cause withdrawal symptoms if taken too soon after your last dose of opioid.

How long will it take to work?

You’ll start on a low dose and work your way up to your regular dose. It’s important, not to take other opioids during this time, as this will give you withdrawal symptoms. Most people feel they are on the correct dose within the first week of treatment.

Coming off Suboxone®

Once you’ve settled into your regular Suboxone® prescription, your recovery worker will talk to you about what your goals are for your treatment. One of the things you’ll talk about is how to reduce your dose and eventually come off it completely. This is called a detox. Your worker and prescriber will take a look at your dose every six weeks and see if they think it should be changed. When you detox, we might swap you over to buprenorphine tablets instead of Suboxone®.

Other notes about taking Suboxone®

• Extra support and counselling from groups such as Narcotics Anonymous can be really helpful when you’re trying to stay off opioids like heroin. Support from family, friends and other people close to you can also make a big difference.

• Every so often during your treatment, a member of our team will ask you to take a drug test to make sure your treatment remains appropriate and safe.

• You should refrain from drinking alcohol or using drugs during your treatment.

• If you drive and you are taking Suboxone® , you should let the DVLA know.

• All drugs must be kept out of reach of children and animals. Please ask your worker for a lockable box to store your medication (free of charge). Children should never be given your medication. They have no tolerance and it could kill them. Always call 999 if you think a child has swallowed your medication. Talk to your Health Visitor or GP if your child has difficulty sleeping or being soothed.

• Speak to your recovery worker or doctor if you experience side effects or symptoms and wish to stop treatment.

• Read the information leaflet which will be given with your medication.