A combination drug containing buprenorphine and naloxone, Suboxone could stay in the system for about a week. This drug is mainly prescribed for treating opiate addiction. This PsycholoGenie write-up provides information on the uses, benefits, and side effects of this drug.
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According to a study conducted by the National Drug Abuse Treatment Clinical Trials Network, supported by the National Institute on Drug Abuse (NIDA), opioid-addicted youths who continued to take Suboxone for 12 weeks were less likely to inject drugs, use opioids, cocaine, and marijuana, or drop out of treatment than those who received short-term detoxification and counseling.
Suboxone is a combination drug that is recommended for treating individuals who are addicted to opioids. It is a combination drug that contains buprenorphine, which belongs to a class of medications called opioid partial agonist-antagonists, and naloxone, which belongs to a class of medications called opioid antagonists. Derived from thebaine, buprenorphine is a semi-synthetic opioid. Being an opioid, it does produce effects that are produced by heroin and methadone. However, the effects produced are mild, as it is a partial agonist. It was due to this reason that the Food and Drug Administration approved its use in combination with naloxone for the treatment of opioid dependence.
Suboxone is prescribed to those who are addicted to substances such as heroin or marijuana, as it reduces their dependence, without causing severe withdrawal symptoms. It is available in the form of a film or tablet, which can be administered as a sublingual medication.
The term ‘half-life’ refers to the duration required for the amount of drug in the body to be reduced by 50%. The half-life of a drug is usually considered in relation to the amount of the drug in plasma. In general, it takes about 4-5 half-lives for most drugs to get completely eliminated from the body. Suboxone is a combination of buprenorphine and naloxone. The half-life of the former ranges from 24 to 42 hours, whereas the half-life of naloxone is 30 to 81 minutes. Thus, taking the half-life of buprenorphine into account and multiplying it by 5, we can conclude that it will take slightly over a week for it to get completely eliminated from the body.
Though Suboxone is not commonly included in the standard drug screen panels, FDA-approved urine drug tests for buprenorphine are available, which are now being used by some employers. Buprenorphine can be detected in urine, hair, or blood with the help of gas chromatography/mass spectrometry (GC/MS). It can be detected in urine with the help of the enzyme-linked immunosorbent assay (ELISA). There are specific urine-based tests that can be undertaken to detect Suboxone. These include liquid chromatography-tandem mass spectrometry (LC-MS-MS) and cloned enzyme donor immunoassay (CEDIA). Even the saliva can be tested for the drug. The detection time for buprenorphine in urine is 1-6 days, whereas detection time for saliva is 6-12 hours after its consumption. Thus, this drug can show up on specific drug tests.
Buprenorphine shows the ceiling effect, which refers to the phenomenon in which a drug reaches a maximum effect (plateau), after which the increase in the dosage of the drug does not increase its effectiveness. It is this effect that makes it an appropriate choice for individuals affected by addiction. As the agonist effects of buprenorphine reach a plateau, the risk of side effects and withdrawal symptoms is much less. Moreover, the effects are already less, as this drug is a partial opioid agonist. Also, buprenorphine has a high affinity for the opioid receptors, and could even prevent other opioids from binding to the opioid receptors.
It is essential that the use of Suboxone for individuals addicted to opioids is supervised. This is mainly due to its potential for abuse. Factors that need to be taken into account include the last time the opioid was used, the nature or type of opioid used (long-or short-acting opioid), as well as the extent to which one is dependent on the opioid. Often the first dose of Suboxone is administered after the onset of the signs of moderate withdrawal.
Buprenorphine can be habit-forming, if it is taken in large doses or in a way other than what has been prescribed. There is definitely a potential for abuse. This is the reason why an opiate antagonist called naloxone is added to buprenorphine. The term ‘antagonist’ refers to a substance that binds to a receptor; however, it doesn’t cause the response that the neurotransmitter or an agonist would cause. Opioid antagonists block the opioid receptor. Thus, when naloxone is added to a partial-opioid agonist, it prevents the effects that opioid use can cause. One of the reasons behind combining these drugs is to prevent the intravenous abuse of buprenorphine by individuals who are physically dependent on other opiates. If this drug is injected, it will give rise to the onset of withdrawal symptoms in individuals addicted to opioids. However, in case of sublingual administration, the effects of naloxone are not significant.
Suboxone should not be recommended for individuals who might be allergic to any ingredient in the drug, or might be hypersensitive to buprenorphine or naloxone. In some cases, it could cause a serious allergic reaction, including an anaphylactic shock. Seek medical assistance at the earliest, if you experience any of the following side effects:
➠ Allergic reaction (Hives, difficulty breathing, closing of the throat, swelling of the lips, tongue, or face)
➠ Slow breathing
➠ Dizziness or confusion
Also, medical assistance must be sought in case of the onset of symptoms related to liver problems, which include:
➠ Yellowing of the skin or eyes
➠ Dark-colored urine
➠ Light-colored stool
➠ Loss of appetite
➠ Stomach pain
Also, inform your healthcare provider, if you experience:
➠ Sleep-related problems
➠ Stomach pain
➠ Redness in the mouth
➠ Loss of sensation in the mouth
Adverse drug interactions could occur, if Suboxone is taken with benzodiazepines, rifampin, erythromycin, HIV protease inhibitors, etc. It should also be avoided by pregnant women, as cases of neonatal withdrawal have been reported in case of the use of buprenorphine by pregnant women. Moreover, it should not be taken by nursing mothers, as buprenorphine can pass into breast milk.
On a concluding note, Suboxone should be taken under medical supervision. It should not be discontinued abruptly, as it can be habit-forming. Seek medical help, if you experience untoward symptoms. In such cases, the doses can be reduced gradually, so as to lower the severity of the withdrawal symptoms.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.