Is Suboxone really “trading one addiction for another”?

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It’s common to hear someone say that taking a recovery medication like Suboxone or Methadone is just “trading one addiction for another.” But is this really the case? Ian Powell, MD, addiction specialist at Rogers, helps us learn the truth about using medication assisted treatment to address opioid use disorder.

Can you become addicted to Suboxone?

This is a frequent question and worry for those who are considering adding Suboxone to their treatment regimen. The short answer: Dr. Powell says addiction to Suboxone isn’t a concern when prescribing the medication.

Part of the confusion is people using the terms “addiction” and “dependence” as synonyms. Dependence refers to the physical cravings and consequences of not taking a drug, like a headache from skipping a morning cup of coffee. While it sometimes co-occurs, it is different than addiction.

“Addiction is out of control use that leads to the substances controlling the priorities of the individual who is affected,” Dr. Powell explains. “Suboxone allows the individual to stop use and reduces cravings for further use of opiates, such as heroin or oxycodone. Sometimes patients feel like they’re stuck on Suboxone and this is where the question of whether it is addictive comes from. But they’re unlikely to die from an overdose, end up incarcerated, lose custody of their children, lose their jobs, or face health consequences associated with substance misuse.”

• Dependence = physical dependence on a substance, usually characterized by symptoms of tolerance and withdrawal
• Addiction = Substance abuse that leads to changes in behavior, usually connected to the biochemical changes in the body and mind

What is Suboxone?

Suboxone is a combination of two drugs: buprenorphine and naxolone—which is better known now as Narcan. Buprenorphine is a long-acting opioid partial agonist that prevents opioid withdrawal symptoms from occurring when it’s taken as prescribed. If someone attempts to misuse Suboxone or takes an opioid, the naxolone blocks opioid receptors, preventing euphoric effects from occurring and instead initiates opioid withdrawals.

How effective is Medication-Assisted Treatment?

Adding a recovery medication to a treatment plan greatly improves outcomes for patients, according to Dr. Powell. He adds that “the greatest benefit is the reduction in mortality from accidental overdoses.”

Studies backup this claim, showing that long-term use of recovery medication helps people achieve long-term, lasting recovery. While their effectiveness is proven, these are not miracle drugs and shouldn’t be thought of as one. Instead, they’re a vital component of treatment.

“Some people may see medications as the sole solution when they will need to make other types of changes as well to help stay sober,” Dr. Powell says. “This would include completing treatments such as intensive outpatient programming (IOP), attending recovery meetings such as Narcotics Anonymous, and avoiding using situations and using peers.”

Even though medication assisted recovery has shown to be effective, stigma can sometimes limit its use. Dr. Powell believes that stigma shouldn’t be associated with medications like Suboxone. Instead, they should be thought of like any other maintenance medication, like someone with asthma using an inhaler.

“Some see recovery medications as a crutch but if you have a broken leg, using a crutch is just fine,” Dr. Powell adds.

Rogers Behavioral Health provides addiction and dual diagnosis treatment for adults and adolescents at locations across the U.S., including inpatient and residential treatment care in Wisconsin. For a free, confidential screening call 800-767-4411 or request a screening online.