Suboxone is a medicine that is used to treat opioid or narcotic drug dependence. This medicine can treat addiction to narcotics such as heroin or morphine. This medicine is used in adults and children over 15 years of age, who are also receiving medical, social, and psychological support. Buprenorphine and naloxone are the two active ingredients in Suboxone.
Suboxone is available in the form of a film that can be placed under the tongue or on the inside of the cheek. There it will dissolve in about five to ten minutes. It should be only used under the supervision of a physician who has enough experience in managing opioid addiction.
How To Use Suboxone?
The prescription of the medicine is done under stricter conditions than normal. Thus the medicine is available only under special prescription. This measure is required to prevent the misuse of the medicine as Suboxone itself can cause addiction.
The correct way Suboxone is used depends upon the patient’s status such as the type of addiction, state of withdrawal, and whether the patient is already using another substitution medication such as methadone before starting this medication. When starting the treatment, the medicine should be placed under the tongue. After the patient gets stabilized on a maintenance dose, the film may also be placed inside the cheek. 4 mg of buprenorphine and 1 mg of naloxone are recommended as a starting dose.
The physician may adjust the dose depending on the patient’s response. But the daily dose should not exceed 24 mg of buprenorphine. Once the patient has been stabilized, the dosage can be reduced gradually, and slowly the treatment can be stopped. Before starting Suboxone treatment the patient’s liver must be checked. The liver should also be monitored regularly during the treatment. Patients who have liver problems are administered lower doses.
Suboxone For Pain Relief
Suboxone is sometimes used as an off-label drug by doctors to treat acute or chronic pain in certain patients. Off-label use of drugs refers to the practice of prescribing a drug for a different purpose than what the FDA approved. Or it can be referred to as an unapproved use of an approved drug. Suboxone is not approved by FDA for use as a pain relief medication. FDA has only approved it to treat narcotic or opiate addiction.
Only the single agent buprenorphine in Suboxone is approved to treat pain. Suboxone can be used for pain only on a doctor’s prescription. You are not supposed to adjust doses by yourself. There have been reports of casualties when people who are not using opioids used buprenorphine doses for pain relief.
Buprenorphine which is an active ingredient in Suboxone has pain-relieving effects and is approved by FDA as a single agent in several forms for pain. Butrans which is an extended-release, transdermal formulation of buprenorphine is approved by FDA for the treatment of moderate to severe chronic pain. Butrans should not be used to treat acute pain on an as-needed basis. Belbuca which is buprenorphine buccal film is also used to treat chronic pain not controlled by other medicines.
These buprenorphine treatments are used when the pain is very severe and require round-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. These medications cannot be used to relieve acute pain quickly or when there is a need for a pain reliever. Buprenorphine injection, which comes under the brand name Buprenex, is also available for pain that is severe enough to require an opioid analgesic and for which alternate pain-relieving treatments are inadequate. Buprenex is given by either intravenous or intramuscular injection.
As mentioned earlier, the FDA has not approved the use of Suboxone for pain relief. Still, doctors use this medicine as an off-label drug in some patients who are already using Suboxone to treat opioid use disorder. There is research conducted on the off-label use of Suboxone for the treatment of both acute and chronic pain. It is reported that the pain-relieving effect of buprenorphine may only last for six to eight hours.
Suboxone For Acute Pain Management
Your doctor may decide to continue the Suboxone treatment for acute pain or for surgery. Doctors also recommend non-drug therapies like applying heat or cold, or physical or behavioral therapy to help to reduce the effect of pain. Non-opioid medications like NSAIDs, acetaminophen, and corticosteroids may also be used by your doctor.
Sometimes regional and local anesthesia may also be used. Doctors may increase the dose of Suboxone (buprenorphine/naloxone) in some patients, and the doses will be given in three or four divided doses per day to control mild to moderate pain. In some cases, your doctor may use some other opioid treatments to control your pain.
Going with the Suboxone treatment will help you to maintain your treatment goals with few risks for fallback, but it may not always be possible. Using other types of opioids along with buprenorphine might make it more difficult to treat your pain. Your doctor will decide to continue with Suboxone treatment on an individual basis.
Suboxone For Chronic Pain Management
Suboxone is increasingly used to treat chronic pain in opioid-dependent patients. When using Suboxone, there is a risk of overdose and even death in patients who are not currently using any opioids. People with opioid use disorders frequently experience chronic pain. In addition to that, opioid use often worsens pain.
This condition can occur when a patient receiving opioids for pain actually becomes more sensitive to pain. Similar to acute pain treatment, chronic pain in opioid-dependent patients must be treated with non-opioid analgesics like NSAIDs or acetaminophen, and non-drug treatments such as physical therapy or behavioral therapy. Your doctor will adjust your dose if the Suboxone treatment is used for both opioid use disorder and chronic pain management.
Suboxone (buprenorphine/naloxone) is a drug used to treat opioid use disorder or narcotic addiction. It is also prescribed by some doctors as an off-label drug to treat acute or chronic pain. It has shown positive results in reducing pain in patients. Those who stayed on this medication required lower doses over time or were able to stop opioids altogether. Always take care to follow the dosing instructions of your doctor.
Dr. Elizabeth Novello
Dr. Elizabeth Novello is a distinguished healthcare professional who has dedicated her career to the specialized field of pain-related healthcare. With a deep passion for alleviating suffering and improving the quality of life for those experiencing pain, Dr. Novello has become a recognized authority in her field. Dr. Novello’s journey in the realm of pain management began with her rigorous medical training, where she developed a profound understanding of the complexities surrounding pain and its treatment.
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