Managing Fentanyl Use: Analyzing Suboxones Impact on Users

October 15, 2024

By Arch Recovery Center

Explore the effects of Suboxone on people who use fentanyl and understand treatment outcomes and risks.

Suboxone and Fentanyl Use

The relationship between Suboxone and fentanyl use has become a focal point of discussion in addiction treatment. Understanding the implications of using Suboxone can help address the needs of individuals struggling with fentanyl addiction.

Precipitated Withdrawal Risks

One concern with starting buprenorphine (the primary component of Suboxone) in individuals currently using fentanyl is the risk of precipitated withdrawal. This type of withdrawal can occur when a partial agonist like buprenorphine displaces full agonists, leading to sudden and intense withdrawal symptoms. However, research indicates that the occurrence of precipitated withdrawal is low among individuals who use fentanyl. In a study encompassing 1,200 participants, only 9 experienced precipitated withdrawal after initiating buprenorphine treatment. This translates to about 1% among those specifically using fentanyl.

Study Participants	Total Number	Precipitated Withdrawal Cases	Rate of Precipitated Withdrawal
Total Participants	1,200	9	0.75%
Fentanyl Users	~840	~8	~1%

Increase in SAMHSA Helpline Calls

The rising awareness of fentanyl addiction and the role of medications like Suboxone has led to increased outreach for help. In 2020, the SAMHSA National Helpline reported 833,598 calls, marking a 27% increase from 2019, which had 656,953 calls for the year. This uptick indicates a growing need for support and treatment options, reflecting the complexities surrounding opioid use disorder and the substitution therapies available.

Year	Calls to SAMHSA National Helpline
2019	656,953
2020	833,598
Increase	27%

The effects of Suboxone on individuals using fentanyl are critical for understanding the larger picture of addiction treatment and recovery. For more information on the complexities of recovery, refer to our article on what makes addiction recovery a challenging process?.

Fentanyl Addiction

Fentanyl addiction is a significant concern given the drug's potency and effects on individuals. Understanding the characteristics of fentanyl and the withdrawal symptoms associated with its use is crucial for effective treatment and recovery.

Fentanyl Characteristics

Fentanyl is a synthetic opioid that is approximately 100 times more potent than morphine and 50 times more potent than heroin as an analgesic. It is often prescribed to manage severe pain, particularly in patients with chronic pain who have developed tolerance to other opioids. This increased potency contributes to its addictive nature, which can lead to dependence characterized by withdrawal symptoms when usage is discontinued.

Dependence can manifest as a severe substance use disorder (SUD), where users exhibit compulsive drug-seeking behaviors and persistent use despite harmful consequences. Given its potency, even a small amount of fentanyl can lead to overdose, making it crucial for individuals to seek help when experiencing signs of addiction.

Withdrawal Symptoms

Withdrawal symptoms from fentanyl occur within hours after the last dose and can be severe, making it challenging for individuals to stop using the drug. Common withdrawal symptoms include:

Withdrawal Symptom	Description
Muscle and Bone Pain	Users may experience intense pain throughout their body.
Insomnia	Difficulty sleeping is a prevalent symptom during withdrawal.
Gastrointestinal Issues	Symptoms may include diarrhea and vomiting.
Cold Flashes with Goosebumps	A notable symptom often referred to as "cold turkey."
Involuntary Leg Movements	Restlessness and twitching in the legs are common.

The severity of these symptoms can vary from person to person, influencing their ability to quit and leading many to continue using fentanyl to avoid the discomfort associated with withdrawal [4].

For those seeking to understand the effects of medications such as Suboxone on this population, exploring treatment options and coping mechanisms is essential. Effective management of fentanyl addiction often requires a comprehensive approach that includes therapy and medications designed to ease withdrawal symptoms. For additional insights into recovery challenges, visit our article on what makes addiction recovery a challenging process?.

Buprenorphine Treatment

Efficacy of Buprenorphine

Buprenorphine is commonly used in the treatment of opioid use disorder, and its efficacy has been supported by various studies. Research indicates that patients on doses of buprenorphine of 16 mg per day or more were 1.82 times more likely to remain in treatment compared to those receiving a placebo. Additionally, buprenorphine has demonstrated the ability to reduce the number of opioid-positive drug tests by 14.2% [5].

Another study highlighted the impact of dosage on treatment outcomes. Those prescribed a buprenorphine dose of 24 mg showed improved retention in treatment over 180 days compared to those on the standard dose of 16 mg [6]. This data suggests that higher doses of buprenorphine can potentially enhance the effectiveness of treatment, especially in populations experiencing challenges with maintaining sobriety.

Dosage Considerations

Dosage plays a critical role in the effectiveness of buprenorphine treatment. Patients prescribed the recommended daily dose of 16 mg were at a significantly greater risk of treatment discontinuation within 180 days compared to those on higher doses. Specifically, 53% of patients who received 24 mg of buprenorphine also discontinued treatment within that time frame, indicating ongoing challenges even with higher dosages [6].

Results from a cohort study conducted between 2016 and 2020 affirmed that a buprenorphine dose of 24 mg associated with improved retention in treatment, particularly during the period of widespread fentanyl use. This highlights the necessity for evaluating higher doses beyond the FDA-recommended range of 16-24 mg to enhance retention rates among individuals trying to overcome opioid dependence.

Buprenorphine Dose	Likelihood of Staying in Treatment	Opioid-Positive Drug Tests Reduction (%)
16 mg	Lower	14.2%
24 mg	Higher (1.82 times)	Not specified

Recognizing the effects of suboxone on people who use fentanyl is essential for optimizing treatment strategies. Ongoing assessment of dosage and its impact on treatment adherence can assist healthcare providers in devising effective individualized treatment plans.

Medications for Opioid Use Disorder

When addressing opioid use disorder, various medications can play a crucial role in treatment. Two primary options are buprenorphine and naltrexone, both of which have been shown to effectively support individuals in recovery.

Role of Naltrexone

Naltrexone is an opioid antagonist that blocks the effects of opioids. It is available in both oral and injectable forms, with extended-release injectable naltrexone (XR-NTX) showing promising results. According to the National Institute on Drug Abuse, XR-NTX significantly increases opioid abstinence rates, with 90% of those in the XR-NTX group remaining abstinent compared to only 35% in the placebo group.

Additionally, XR-NTX treatment exhibited a 58% treatment retention rate and decreased cravings and relapse rates, making it a valuable option for those seeking to overcome addiction. This medication is particularly effective after detoxification, as it prevents opioid effects, minimizing the risk of relapse.

Comparing Buprenorphine and Naltrexone

Both buprenorphine and naltrexone are effective in treating opioid use disorder, but they function differently. Buprenorphine is a partial agonist, which means it activates opioid receptors to a lesser degree than full agonists like fentanyl. This can help reduce cravings and withdrawal symptoms without producing the same level of euphoria.

A study from the National Institute on Drug Abuse indicated that once treatment was initiated, a combination of buprenorphine and naloxone, along with extended-release naltrexone, showed comparable effectiveness for opioid use disorder treatment after the detoxification process.

Summary Table: Comparison of Buprenorphine and Naltrexone

Medication	Type	Function	Effectiveness Rate
Buprenorphine + Naloxone	Partial Agonist	Reduces cravings and withdrawal	High, post-detox
Extended-Release Naltrexone	Opioid Antagonist	Blocks opioid effects	90% abstinence rate

Understanding the differences and benefits of these medications can assist individuals and healthcare providers in making informed decisions about the most appropriate treatment options for opioid addiction. For more information about the effects of Suboxone on people who use fentanyl, further resources can be explored.

Suboxone Overview

Suboxone plays a significant role in addressing opioid dependence, particularly in individuals using fentanyl. It consists of buprenorphine and naloxone, both of which are essential in medication-assisted treatment (MAT).

Use in Medication-Assisted Treatment

Suboxone is classified under opioid antagonists, which negate the effects of opioids by preventing them from activating pain receptors. It effectively manages cravings and reduces withdrawal symptoms. This pharmacological approach assists those struggling with addiction to regain control over their lives while decreasing the risk of relapse.

Suboxone has a lower dependency risk compared to methadone, making it more suitable for long-term use without the severe habit-forming potential often associated with other opioids [7].

Suboxone Forms and Benefits

Suboxone is available in two primary forms: a tablet and a sublingual film. Both variants dissolve in the mouth, providing effective results in managing addiction.

Form	Key Features
Tablet	More discreet, sometimes less expensive
Sublingual Film	Allows for tapering doses in smaller increments

These forms cater to different patient preferences. While tablets might be favored for their convenience, the film's capacity to personalize dosing can be advantageous for users looking to gradually reduce their intake. Clinical trials confirm that Suboxone is effective for reducing opioid misuse and retaining users in treatment for up to 24 weeks.

Suboxone is classified as a Schedule III controlled substance due to its potential for misuse and the establishment of stringent guidelines for its prescription. Doctors must receive special training and certification to prescribe Suboxone for treating opioid dependence. Understanding the effects of Suboxone on people who use fentanyl is crucial in evaluating its effectiveness in recovery.

Suboxone Considerations

Safety and Side Effects

Suboxone is classified as a Schedule III controlled substance due to its potential for causing physical or psychological dependence and being misused. The U.S. federal government has put specific regulations in place for prescribing and dispensing Schedule III drugs. Doctors can only prescribe Suboxone for opioid dependence after receiving special training and certification [8].

When misused, Suboxone can lead to serious consequences such as overdose, dangerous side effects, and even death. This risk is heightened when it is combined with other opioids, alcohol, or benzodiazepines. Misuse may also induce severe withdrawal symptoms, while taking high doses can lead to respiratory issues, coma, or death.

Possible Side Effects	Description
Physical Dependence	Risk of developing dependence on the medication.
Constipation	Common gastrointestinal issue.
Hormone Problems	May lead to hormonal imbalances.
Insomnia	Difficulty sleeping can occur.
Sweating	Increased perspiration noted by some users.
Rash	Skin reactions may develop.

Long-Term Use Risks

Long-term use of Suboxone can heighten the risk of various side effects. These may include physical dependence, constipation, headaches, insomnia, weight fluctuations, and rash. It is particularly noteworthy that discontinuing Suboxone abruptly can trigger mild withdrawal symptoms. Additionally, there are concerns about potential liver damage in some users.

Risks of Long-Term Use	Description
Dependence	Developing a reliance on the medication.
Constipation	Ongoing gastrointestinal discomfort.
Mild Withdrawal Symptoms	Symptoms emerging if the medication is stopped suddenly.
Liver Damage	Potential for liver health issues.

These considerations are vital in understanding the overall effects of Suboxone on people who use fentanyl. For those engaging with Suboxone as part of their treatment for opioid dependence, it is critical to consult professionals about both short-term and long-term risks.