17 Aug Suboxone for Opioid Dependence

Opioid Dependence is beyond an emerging problem in this country. It is no secret that it is now a national epidemic and public health crisis. Fueled by aggressive marketing and manufacturing strategies by the pharmaceutical industry; government incentives aimed toward reducing pain and labeling pain as the “5th Vital sign,” and then tying patient satisfaction and reimbursement to subjective pain scores; the compassionate tenants of our society; some unscrupulous physician practices; and misinformation to providers and patients alike, regarding the long term effects of opioids. We now find ourselves faced with the daunting task of re-orienting our approach to pain management and the expectations around pain control.

Suboxone therapy or buprenorphine along with psychological, and traditional medical services appears to be the treatment of choice at this time. Increasing access to this medical modality and helping providers and patients identify opioid dependency is the first step toward restoring a state of internal harmony for patients that sit at the crux of this historical nightmare.  

Buprenorphine is known as a partial agonist and partial antagonist. Meaning it partially acts on the opioid receptor, and partially blocks the opioid receptor. This is in comparison to drugs such as Heroin, Morphine, Fentanyl, Oxycodone (found in Percocet), Hydrocodone (found in Vicodin), as well as Codeine that act only as an agonist (receptor activator).  

The analgesic (pain relieving effects) of an opioid molecule primarily take place with Mu receptor activation in the Ventral Tegmental Area, Nucleus Accumbens, and Locus Coeruleus regions of the brain.  

Naltrexone and naloxone are examples of additional drugs that bind to the Mu receptor. However, unlike Buprenorphine, these molecules have pure antagonist effects. That means they block the Mu receptor and prevent the analgesic effects of opioids, along with some of the other potential effects of opioids such as sedation and respiratory depression (slowed breathing) or failure (the inability to breadth). That is why these drugs are employed respectively, to help people avoid opioids altogether or treat opioid overdoses.

Buprenorphine, Naloxone or Naltrexone, and molecules such as Heroin and Vicodin, have different levels of affinity to the mu receptors in the brain. They also have different lengths of time for which they bind to the opioid receptor before releasing their grip on these Mu receptors.  

Understanding this complex pharmacology, neurological, and behavioral reward system; and how these molecules impact an individual’s cognitive-emotional state, behavior, and overall functioning; is critical to restoring a state of physiological, mental, and spiritual well-being.

Discuss with your physician if Suboxone Therapy is a treatment option for you.