Jul
31

Addiction: Suboxone To Use Or Not To Use!!!!

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Addiction: Substitution Good Or Bad?

  It seems as in America the trend amongst doctors dealing with addiction is to subscribe to the philosophy of better living through chemistry. It appears that there is a supposed miracle pill for every ailment including addiction. The latest buzz in the addiction treatment field is Suboxone, generically known as buprenorphine and naloxone. It has become so popular that pharmacies are offering coupons for Suboxone.  Many argue that Suboxone is just substituting one drug for another and isn’t an effective treatment as it never truly gets to the root of the addiction. Others argue that it is very effective and that they have had great results.

 Dr. James Schaller is a proponent of using Suboxone and has written his findings in this book.

Many others on the other side point to the side effects and suggest alternative treatments.

Addiction: Suboxone Side Effects

  As I searched www.drugs.com I found the following and started to agree with those who do not prescribe Suboxone. The decision is strictly yours.

Applies to buprenorphine / naloxone: sublingual film, sublingual tablet

Get emergency medical help if you have any of these signs of an allergic reaction while taking buprenorphine / naloxone:  hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other narcotic medicines, buprenorphine can slow your breathing.  Death may occur if breathing becomes too weak.

Call your doctor at once or seek emergency medical attention if you have:

  • extreme drowsiness;
  • loss of coordination, weakness or limp feeling;
  • blurred vision, slurred speech, thinking problems;
  • weak or shallow breathing;
  • nausea, upper stomach pain, itching, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
  • pounding heartbeats or fluttering in your chest; or
  • withdrawal symptoms–diarrhea, vomiting, shaking or shivering, runny nose, watery eyes, muscle pain, and feeling very hot or cold.

Common side effects may include:

  • headache, mild dizziness;
  • numbness or tingling;
  • drowsiness, or sleep problems (insomnia);
  • stomach pain, vomiting, constipation;
  • redness, pain, or numbness in your mouth;
  • feeling drunk; or
  • trouble concentrating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For Healthcare Professionals

Applies to buprenorphine / naloxone: sublingual film, sublingual tablet

General

Side effects affecting the body as a whole in opioid dependent patients have included asthenia (6.5% vs 6.5% with placebo), chills (7.5% vs 7.5% with placebo), headache (36.4% vs 22.4% with placebo), infection (5.6% vs 6.5% with placebo), pain (22.4% vs 18.7% with placebo), abdominal pain (11.2% vs 6.5% with placebo), back pain (3.7% vs 11.2% with placebo), and withdrawal syndrome (25.2% vs 37.4% with placebo).
Chronic administration of buprenorphine may result in dependence and withdrawal symptoms may occur upon abrupt withdrawal.  The naloxone component may produce severe withdrawal symptoms if buprenorphine-naloxone is injected by opioid-dependent individuals. Sublingual buprenorphine-naloxone may also cause withdrawal symptoms if taken before the opioid agonist effects have subsided.

Other

Neonatal withdrawal has been reported in infants of women who took buprenorphine during pregnancy.

Nervous system

Nervous system side effects in opioid dependent patients have included insomnia (14% vs 15.9% with placebo).  Increased CNS depression may occur in patients receiving concurrent CNS depressants (e.g., narcotic analgesics, general anesthetics, benzodiazepines, phenothiazines, tranquilizers, sedative/hypnotics, or alcohol).  Buprenorphine may elevate cerebrospinal fluid pressure.  Side effects associated with buprenorphine alone have included anxiety, depression, dizziness, insomnia, nervousness, and somnolence.

Respiratory

Respiratory system side effects in opioid dependent patients have included rhinitis (4.7% vs 13.1% with placebo).
Respiratory depression has been associated with buprenorphine, particularly after intravenous administration.  Death has occurred with intravenous misuse of buprenorphine, usually with concurrent benzodiazepines, alcohol, and/or other CNS depressants.

Gastrointestinal

Gastrointestinal side effects in opioid dependent patients have included constipation (12.1% vs 2.8% with placebo), diarrhea (3.7% vs 15% with placebo), nausea (15% vs 11.2% with placebo), and vomiting (7.5% vs 4.7% with placebo).  Buprenorphine may increase intracholedochal pressure.

Endocrine

Endocrine effects in opioid dependent patients have included sweating (14% vs 10.3% with placebo).

Hypersensitivity

Hypersensitivity reactions associated with buprenorphine have included rash, hives, pruritus, bronchospasm, angioneurotic edema, and anaphylactic shock.

Cardiovascular

Misuse of crushed buprenorphine tablets by inhalation has been associated with chest pain and acute anterior myocardial infarction in a 22-year-old male.

Cardiovascular side effects in opioid dependent patients have included vasodilation (9.3% vs 6.5% with placebo).  Buprenorphine may cause orthostatic hypotension.

Ocular

Ocular side effects associated with buprenorphine may include miosis.

Hepatic

Hepatic side effects associated with sublingual buprenorphine have included cytolytic hepatitis and hepatitis with jaundice in opioid addicts.  Preexisting liver dysfunction, hepatitis B or C virus infection, injectable drug use, or concomitant hepatotoxic drugs may have had contributory roles.  Baseline and periodic monitoring of liver function tests is recommended during therapy.  Close monitoring or careful discontinuation is recommended if a hepatic adverse reaction is suspected.

Psychiatric

Auditory and visual hallucinations have been associated with parenteral and sublingual buprenorphine.

Addiction: Suboxone – What is Your Decision?

When dealing with treatment options for your addicted child the choice is theirs to get help, however if they seek your input on Suboxone you can now give them information so they can make an informed decision  to use or not to use Suboxone.

 The debate will rage on whether to use or not to use Suboxone as a treatment for addiction. The best thing you can do as a parent is become educated so you can help other parents to make a decision to use or not use Suboxone as a treatment for addiction.

When you type in Suboxone into a Bing or Google Search you will find much more information. Please share your thoughts about Suboxone under comments. Until next time Stay Positive!!!

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