Opinion: Why Suboxone Maintenance Doesn’t Work

There is no doubt in my mind that Suboxone is a helpful tool in leading the way to recovery. Studies find that the main obstacle to abstinence and recovery is the fear of withdrawals. From personal experience, I do believe Suboxone is a helpful tool in the first step to recovery from opiate addiction. That is, when prescribed responsibly by the doctor and taken correctly by the patient. That being said, I do not endorse the long term use of Suboxone (or methadone maintenance for that matter).

Suboxone is a drug that contains both an opioid and an opioid blocker. The way it works is, at the onset of withdrawals, the opiate addict begins the Suboxone therapy (at a therapeutic dose, read: low dose). Suboxone treatment should only last about a week and involves a rapid taper, meaning, the patient takes a full dose the first couple of days and then takes less and less the following days until they stop completely. When used properly, the patient will have experienced less-acute withdrawal symptoms. There is no magic bullet; you will still go through withdrawals but it will be way more tolerable than quitting cold turkey.

My Experience 

During the years of my addiction, I had periods of abstinence and usually could stop on my own. At one point, I had gotten in over my head, though, and, without doing any research into it, started going to a methadone clinic. After about 8 months of that, I decided that enough was enough and decided to quit cold turkey. Again, I didn’t really know what I had gotten into and so, needless to say, the next couple of months were – how can I describe it – hell on earth. After that, I had a period of abstinence from opiates but I was still smoking a lot of weed. I eventually started using again.

About a year before I actually decided to get clean, I was under the care of a psychiatrist who also happened to be trained in prescribing Suboxone (not all doctors have this authority). He treated me with Suboxone and I was relieved to be “back on track” and no longer having to use on a daily basis to keep from being dope sick. But, even for that week on Suboxone, I was still an addict: finding a way to inject it instead of taking it as prescribed. I stayed away from my drug of choice for a little while but, soon enough, life’s stresses drove me back to my old ways. I was using illicit drugs interspersed with Suboxone that I would buy off the street. In fact, I knew a lot of people who used it in the same way: doing Suboxone maintenance for a while, then purposely stopping it in order to do straight opiates such as painkillers and heroin. Off and on, like that, cycling Suboxone for heroin or roxies.

Dirty Docs

It was slowly dawning on me that I had a real problem for which I needed professional help again. At this point, I went to a Suboxone doctor in order to get my own prescription and to get his help with tapering off. At my first and only visit, the doctor instructed me to take the Suboxone at a higher dose than I was doing on my own. And when I told him it was my goal to be tapered off as soon as possible, he said we would “talk about it” in a couple of months. This is all too often the case with Suboxone doctors, also known as “dirty docs.” You see, Suboxone maintenance like methadone maintenance, is not covered by insurance – it is all an out-of-pocket expense. Therefore, dirty docs charge their desperate opiate-dependent patients an arm and a leg and then pocket most of that money.

Suboxone is Not Effective at Preventing Relapse

From personal experience and seeing others use and abuse Suboxone, it is clear to me that it is not effective at treating relapse. In fact, studies have identified the specific parts of the brain that deal with relapse; medications like Suboxone do not activate the areas of the brain associated with relapse. Furthermore, these studies find that the chronic blockade of opioid receptors has anti-reward effects which increase the potential for relapse.

If you or someone you know is in need of painkiller, heroin, or Suboxone addiction treatment, please give us a call at 800-951-6135.