Suboxone is the combination of two different drugs: buprenorphine and naloxone. Buprenorphine, a partial opioid agonist, blocks the opiate receptors and reduces a person’s cravings. The second ingredient, naloxone, is included to discourage injection of Suboxone. When taken as prescribed sublingually, naloxone has no effect; whereas, if injected it acts as an antagonist that it is and can precipitate withdrawal. As a partial opioid agonist, with a very high affinity for the opioid receptor, buprenorphine provides relief from opioid withdrawal to a patient who has Addiction involving opioids. It provides a way for the individual to be gradually weaned off other opioid use while minimizing the opioid withdrawal symptoms.
Who is this program for?
Suboxone is used to treat Addiction involving opioids. As buprenorphine has a very high affinity for the opioid receptor and it is a partial agonist, it displaces other opioids and can precipitate withdrawal in people who take it in conjunction with other opioids. So, there has to be a reduction in the opioid use and presence of withdrawal symptoms before Suboxone can be started. The individual has to be willing to experience some withdrawal symptoms, which are quickly relieved within 24-48 hours and stabilization is achieved within a week.
How is the program delivered?
Suboxone is an opioid prescription medication containing buprenorphine 2 mg and 8 mg (in sublingual tablets) in fixed combination with naloxone 0.5 and 2 mg respectively (to deter injection drug use). Sublingual dissolution of Suboxone tablets usually takes 2 to 10 minutes. Individuals need to commit to being in withdrawal at the beginning and come for an appointment everyday for at least 5 days. At HUM, the physician will start you on 4 mg buprenorphine that may be supplemented by another 4 mg later in the afternoon of the first day. The dose is titrated up on a daily basis until stability is achieved, usually within 7 days. It is important to tell your doctor how you feel when you take it. If you decide to taper or stop using Suboxone, it is important to do so in consultation with your prescribing physician.
When can someone start the program, how does one start, and are there any prerequisites?
Anyone wanting to start suboxone treatment must first complete HUM’s comprehensive assessment in order to determine eligibility for suboxone and appropriate dosage. Anyone can self-refer to HUM and there is no wait list. All it takes to get started is a phone call.
What are the costs?
After the comprehensive assessment has been completed, the only cost is for the suboxone prescription and the point of care testing (POCT) for urine drug screens. While taking suboxone, POCT will be 1-2 times/month at a cost of $90/test.All appointments with the HUM physician are covered by Alberta Health Care.