As the opioid epidemic rages on, buprenorphine treatment is more critical than ever. Suboxone and other buprenorphine products are preferred medication-assisted treatment (MAT) options. While starting MAT can be scary, your anxieties can be alleviated with a bit of knowledge.
Do not allow fear of MAT to prevent you from seeking this highly effective preferred medication for opioid use. Knowing what to expect and how to adhere to your treatment can help you establish a strong, long-lasting recovery from opioid use disorder (OUD). Similarly, understanding the most common problems buprenorphine clients face can spare you from unpleasant experiences. Let’s talk about some of these issues and how to solve them.
Start Buprenorphine Treatment Correctly
Starting buprenorphine treatment appropriately minimizes side effects and helps you stabilize faster. Buprenorphine products require a prescription. This means you will be working with a doctor. The two most popular options for opioid recovery are Suboxone and Subutex. Suboxone is a combination of buprenorphine and naltrexone, the same active ingredient as Narcan.
It is crucial to wait a bare minimum of 24-36 hours between your last short-acting opioid dose and your initial buprenorphine treatment dose. Some physicians may require you to present in the office and demonstrate symptoms of withdrawal. Clinicians use a tool called the COWS scale to assess withdrawal. This practice informs the determination of whether starting buprenorphine is appropriate at that time.
The timing of the first dose is critical to completing the induction phase of buprenorphine treatment. If any opioids remain in a person’s system, MAT drugs like Suboxone cause a painful condition called precipitated withdrawal. Precipitated withdrawal is the most common early complication of buprenorphine products.
Buprenorphine is such a high-affinity substance that it will ”kick” any remaining opioids off of the receptors in a manner similar to Narcan. Unlike Narcan, however, buprenorphine is extremely long-acting. The result of using either on an opioid-dependent person is the same: immediate, crushing withdrawal.
Unfortunately, precipitated withdrawal cannot be treated, only waited out. More buprenorphine won’t make the client feel better, nor will conventional opioids. You can avoid this distressing situation by ensuring you follow your doctor’s instructions to the letter.
Be Aware of Common Side Effects
Though highly effective for OUD, buprenorphine treatment is not without side effects. While a genuine allergic reaction to the medication is extremely rare, adverse reactions aren’t uncommon. The issues most people encounter during buprenorphine treatment are attributable to induction or instability. In short, the medication is either insufficiently or excessively dosed. A person is considered stable on products like Suboxone and Subutex when they are symptom-free for a full 24 hours.
Underdosing buprenorphine carries many of the same side effects as standard opioid withdrawal. This is often because the dose is inadequate for the recovering person’s history or tolerance. Some of the most common symptoms of a dose being too low, infrequent, or otherwise inefficacious include these:
- Digestive issues, such as nausea, vomiting, and diarrhea
- Hot cold flashes and chills
- Excessive sweating
- Sneezing and tearing eyes
- Anxiety and panic attacks
- Low back and muscle pain
Buprenorphine can also have serious side effects from excessive dosing. If the dose is much higher than the client’s tolerance, symptoms are typically obvious and mimic those of opioid overdose. Fatal overdoses do occur, but fortunately, they are rare and typically involve intentional abuse or mixing of other substances. The risks of inappropriately high dosing can be prevented by addressing symptoms with your provider. According to the Mayo Clinic, these are the primary indicators that an individual’s buprenorphine dose is too high:
- Fainting or light-headedness
- Pinpointed pupils
- Confusion and weakness
- Respiratory issues, including slowed or labored breathing
- Sleeping disruptions, particularly excessive sleep
- Physical fatigue
- Depression symptoms
Advocate for Yourself Appropriately During Buprenorphine Treatment
When you experience a problem during your buprenorphine treatment, the solution is simple but not always easy. You must communicate candidly with your prescriber. Many of us begin recovery not knowing how to advocate for ourselves. That’s okay. However, as a MAT patient, you can begin learning self-advocacy with these simple practices:
- Keep your appointments: This is particularly crucial for initiating buprenorphine treatment. That said, accountability and compliance help mitigate the potential risks of using this medication.
- Report and discuss side effects with your provider: Most physical or mental issues experienced on buprenorphine can be waited out or addressed. However, this is only the case when you tell your prescriber precisely which symptoms you’re experiencing.
- Be honest and open: If the treatment isn’t working for you, say so. There may be a medical reason why. While nobody wants to tell their doctor about issues like cravings, you may be a simple dose adjustment away from preventing relapse. If your doctor isn’t treating you fairly or you feel the treatment isn’t effective, seek a second opinion.
Advocating for yourself is crucial, particularly with your healthcare providers. Remember, your doctor is there to provide guidance and make necessary adjustments. Buprenorphine clients may find they need different dosing, additional comfort medications, or psychiatric treatments to fully stabilize.
Finally, if buprenorphine isn’t effective for you, assess why. Your prescriber may have insights. It is never too late to learn more about other MAT options, such as methadone and naltrexone, which are more suitable for some people. Not all people who use opioids respond effectively to a single treatment. At West Coast Recovery Centers, we understand the complexity of the issues at hand. Our clients retain the autonomy to work with their treatment team and execute a concrete plan that may include MAT.
At West Coast Recovery Centers, we allow and encourage MAT for one simple reason: it works. We respect the right of all of our clients to use the best recovery tools for them. It is our firm belief that treatment is a relationship. We never force anyone to follow one path because we fundamentally do not believe in cookie-cutter recovery. MAT for opioid recovery is an evidence-based standard with an abundance of supporting research. These scientific standards matter at West Coast Recovery Centers. We realize that some people need medications such as Suboxone to taper or prevent relapse. If you have additional questions about our programs, residences, or policies, call our experts at (760) 492-6509.