1. Do I Need To Be In Withdrawal To Start Suboxone?
Yes, you do. If not, the opiates on your mu pain receptors will be kicked off of them by the buprenorphine molecules and you will immediately go into a terrible withdrawal which cannot be effectively treated. You won't die but you'll be miserable for a long time. You don't want to try it.
2. What If I'm Pregnant?
You can be treated for opiate addiction when pregnant but not with Suboxone. If you are pregnant, your care will be coordinated with your obstetrician. You will need to be on Subutex until you deliver or until you are no longer nursing your baby. Suboxone has a higher risk of harm to a fetus than does Subutex.
3. What Is Subutex?
Subutex is pure Buprenorphine. It is not a treatment for opiate addiction. It is a medicine which alone is addicting. It is not permitted in the United States for treatment of opiate addiction unless you are pregnant or have a proven allergy to Suboxone.
4. What Are The Other Medical Treatments For Opiate Addiction And What Are Their Results Like?
Methadone clinics are a standard treatment for opiate addiction. Methadone can only be prescribed in a licensed facility for addiction. An MD with a DEA license allowing for opiate prescription can prescribe it but only for pain, not for addiction treatment. For addiction, Methadone must be received from a licensed clinic. Methadone is a good, effective treatment for opiate addiction. However, it requires a great deal of supervision and time on the part of the patient.
Naloxone is also a treatment for opiate addiction. It is effective. The patient must be highly motivated because, if the patient wants to abuse again, he/she only needs to stop the Naloxone and can then go back to abusing opiates. While taking Suboxone, there is less desire to stop the medication because it produces a feeling in most patients like they never ever abused. Naloxone alone doesn't seem to provide that feeling for addicts.
5. Is It tough To Come Off Suboxone?
In my clinical experience, it is difficult to come off Suboxone for most patients. However, it can be done and I've had success with it, helping patients come off Suboxone.
6. Do I Need To Come Off Suboxone?
The DEA has allowed Suboxone for maintenance treatment for opioid dependence. However, many patients want to come off it. The clinic has no opinion on the subject. Dr. Fettman discusses the pro's and con's of coming off with the patient. It is the patient's ultimate decision.
7. Why Is It Hard To Find Addiction Treatment For Opioids?
There are many reasons for this. Addicts are traditionally a difficult patient population to work with, so many doctors choose not to work with addicts. Also, the US government has set a limit of 100 patients for each doctor who wishes to work with Suboxone patients. This also may tend to limit availability. Also, the Suboxone prescribing doctor must take extra training to be able to receive a DEA license for subscribing Suboxone.