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Suboxone is a drug first marketed in the United States in 2004. Since that time, Suboxone is very safe and extremely effective in helping patients overcome their addiction to opiate (or narcotic) type drugs. Video from HBO: Opiate Addiction: A New Medication
It’s an excellent question and one that has been asked not only by addicted people but also with much skepticism by many people who are employed by the “Addiction Treatment Industry.” Other skeptics include 12 step-based NA or AA groups who hold a near-monopoly on addiction treatment in the United States, and, now, sadly, elsewhere.
The same question is also asked by uninformed physicians who fail to understand addiction properly or dislike addicts in general. In many cases, this is for a good reason. Addicts frequently try to feign painful illnesses to “hustle” the physician into prescribing opiate medications. Many of these patients see multiple physicians and utilize multiple pharmacies (“doctor shopping”), at great expense of time, money, and high legal risk.
The answer to the question lies in the unique pharmacology of Suboxone® (generically known as buprenorphine). The truth is Suboxone® is not a new drug. It is itself a type of opiate drug used extensively in Europe, and less so in the U.S., as an injectable form of analgesic (anti-pain) medication. Its paradoxical usefulness in helping opiate-addicted patients overcome their addiction was also recognized years ago. But the F.D.A., much influenced by groups in the addiction treatment industry, delayed its approval for use to treat opiate addiction until the mid-2000s.
Until President Clinton signed into law the Drug Abuse and Treatment Act of 2000 (DATA 2000), it was illegal to treat or maintain an addiction by administering any controlled substances. There was one exception – a tightly regulated, challenging access maintenance system by government-regulated methadone clinics. It proved problematic because of the relatively low number of methadone clinics, their location in bad inner-city neighborhoods, and the burden of daily, or almost daily, visits to obtain the medication.
Aside from this issue, methadone itself is a problematic drug. Unlike buprenorphine, it merely substitutes addiction to heroin (or other opiate drugs) for another toxic and, in many cases, potentially life-threatening drugs. In all fairness, methadone is not without its advantages, the main one being the cost (it is very cheap)
Because Suboxone® (buprenorphine) has a unique pharmacologic profile, it has virtually no intoxicating effect. Simultaneously, it partially stimulates the mu (pronounced “myou”) receptors in the brain and elsewhere in the body.
It is these mu receptors that the opiate addict seeks to stimulate, generally with full mu agonist drugs such as Vicodin®, Lorcet®, Oxycontin®, Dilaudid®, codeine, heroin, and similar drugs. As such, Suboxone® (buprenorphine) mimics the effect of naturally produced endorphins in the body, a polypeptide associated with natural highs, such as the “runner high,” the daredevil’s high,” and the high associated with orgasm, etc.
Both buprenorphine and naturally produced endorphins give one a feeling of well-being that is artificially achieved by opiate abusers using full mu agonists. While the feeling of well-being achieved by using buprenorphine is also artificial, it can be likened to replacing natural insulin with “artificial” insulin in a person with diabetes. A person with diabetes can reduce or even eliminate his disease using natural methods such as weight loss and diet. Similarly, many opiate addicts need to work on their addictions using additional psycho-behavioral therapy.
I have seen many opiate addicts spontaneously go into remission with buprenorphine alone, without psycho-behavioral therapy. Contrary to popular advice, most of my patients can achieve long-term abstinence on Suboxone® alone.
My office is conveniently located in the Los Angeles, CA area.