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Suboxone and Subutex – How Are They Used? Part One
John Wayne once said, “Courage is being scared to death and saddling up anyway.”
There are few things scarier than being trapped by drugs or alcohol. Many of our Novus Medical Detox Center patients come to us because they want help escaping from this horrible trap. In almost every case, our patients have tried to detox on their own. In almost every case, they were unsuccessful because of the pain and severe discomfort they experienced and resumed taking the drug or drinking alcohol.
What type of discomfort? Probably the best description we have heard from our patients is that it is like the worst case of the flu they’ve ever had but ten times worse than that. Chills, sweating, diarrhea, vomiting, fever, cramps, insomnia, and the list goes on and on. You don’t feel like eating or drinking and as you become more dehydrated the discomfort increases. Some people have told us about this state continuing for weeks and not being able to sleep more than a hour at a time and seldom more than a total of a couple of hours a day.
It is frightening to decide that you are going to do something even if there is the type of discomfort described above associated with it. Yes, before they come to Novus they have heard from our Admissions Counselors that we have successfully taken many patients off the same drug and the same amount of the drug that they are taking, but they still have their doubts. Logically, someone else’s experience may not be their experience. I think it is true that all of us believe that minor surgery is somebody else’s surgery because any surgery on you is major surgery. This is the same perception felt by most of our patient about withdrawing from drugs at a medical detox facility—no matter what other people experienced.
Quite often the concern of our patients about the discomfort they will feel while detoxing from opioids like OxyContin, methadone, heroin, Vicodin or Percocet is increased when they learn that we use buprenorphine in our protocol. Why? They have heard, or in some cases personally experienced, a bad reaction after taking Suboxone or Subutex–two drugs whose principal ingredient is buprenorphine.
We tell them that our patients uniformly don’t have bad reactions to Suboxone. Then our nurses and counselors explain why and, like in all other aspects of their lives, once they understand the way buprenorphine should be and is used at Novus Medical Detox Center, they relax a bit. However, until they actually see the process work on them—they are still skeptical. Again, what may work for someone else may not work for them.
The purpose of this newsletter is to explain how buprenorphine works and why, in the hands of skilled medical personnel, it is a powerful tool to reduce the discomfort of opioid withdrawal.
ENDORPHINS AND OPIOID DRUGS
Before understanding how buprenorphine works, it is necessary to understand the way that opioids (OxyContin, methadone and Vicodin) work in our bodies. Opioids activate receptors in the brain that increase endorphin production.
Endorphins are protein molecules that bind with receptors located in your brain, spinal cord, and other nerve endings. Simply put, endorphins block pain signals from reaching the brain. Were it not for endorphins, many of the normal acts of life—breathing, walking, talking–would be uncomfortable or even painful.
The body naturally produces endorphins by sending chemicals to activate endorphin- producing receptors. For our normal activities, the body normally does a good job of keeping us from feeling pain. However, if we experience unusual pain, like from a bad fall, the body may not create enough endorphins to block the pain signals and we will feel the pain. If at that time we were to take an opioid, the drug would activate endorphin-producing receptors and block the pain signals by increasing the endorphin production in the body.
Taking one or two of these pills to block the pain signals while the body is healing is not going to create dependence or addiction. You are still taking drugs that disrupt your body’s normal functions, but much more serious problems can and do arise when the pain blockers are taken for longer periods of time which can lead to dependence or addiction.
DEPENDENCE AND ADDICTION
There is a great deal of confusion about the difference between dependence and addiction. You are said to be dependent on any substance from which you experience uncomfortable symptoms when you stop taking the substance.
It doesn’t have to be an opioid like OxyContin or methadone to create dependence. Many of us have become dependent on sugar or caffeine. When we tried to stop eating sugar or drinking coffee or caffeinated beverages, we experienced uncomfortable symptoms—headaches, cramps or others, for example.
However, for the person becoming dependent on opioids, the withdrawal symptoms can be much more uncomfortable and can continue for longer periods of time. In fact, many people who have become dependent on these drugs no longer take them because they need them to block pain signals but because they don’t want to go through the painful withdrawal that will occur when they stop taking the drug.
Addiction is the condition where a person will modify their behavior and even do destructive things to satisfy the craving created by a drug. They may have originally taken the drug to block pain signals but they continued taking the drug because it allowed them to “feel” a certain way or avoid feeling a certain way. People who become addicted to these drugs are also dependent on the drugs and will experience not only the pain of withdrawal but also the emotional pain of no longer having the drug modify the way they feel.
HOW DO THESE DRUGS CREATE DEPENDENCY AND ADDICTION?
Our bodies are incredibly sophisticated at doing things for us. If the body senses that a particular chemical is needed, unless there is some structural problem, it will try to produce the chemical. If someone is using a chemical, like OxyContin for example, to stimulate endorphin activity, their brain senses that it doesn’t need to produce the natural chemicals to make endorphins. The brain decreases its own endorphin production and relies on the drugs.
You need endorphins to keep from getting very sick—the worst flu only ten times worse. If the brain is not creating endorphins but relying on the opioid, then if you stop taking the opioids you will not have enough endorphin production and will get very sick.
PAIN HAS A PURPOSE
Like all sensations in our body, such as thirst or hunger for example, pain serves a useful purpose for us. Pain is used by the body to indicate that there is a problem that needs to be handled.
We have had a number of patients come to Novus to detox from opioids who began to experience a toothache as they were withdrawing. The toothache got worse and we took them to a dentist. What the dentist found was that they needed not just a cavity filled, but the decay had progressed to the point where a root canal or even an extraction was required. The opioids had flooded the brain with endorphins and prevented the early signs of tooth decay from reaching the brain. Had they not been on the opioids, they would have felt the pain, gone to the dentist and had the cavity filled.
Other patients on opioids relate how they permanently damaged their backs because they were working in construction and lifted too much. Without the opioids, when you lift too much you will feel the pain or discomfort in your back and know that you need to stop. However, because of the opioids the pain warnings never reached the brain so they just kept hurting their backs until the damage was irreversible.
Next week, Part Two of this newsletter will discuss:
The three types of opioid drugs;
How each of these three types affect the body;
Buprenorphine, Suboxone and Subutex and how they are used at Novus Medical Detox Center.
At Novus Medical Detox Center we believe that it is important to ensure that not only do we have the most effective medical protocols but that we also educate our patients so they can better understand what the drugs they were taking were doing to their bodies and how our protocols are going to work. The more that they understand, the more empowered our patients will be to act as a full partner in the process of gaining freedom from drugs or alcohol. Our patients “saddled up” and came to Novus to become free and we are proud that we can help them in this noble cause.
If you know anyone that needs to medically detox from OxyContin, Vicodin, Percocet, antidepressants, anti-psychotics or alcohol, please let them know about Novus Medical Detox Center. We are here to help.
NOTE: This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine, health care diagnosis or treatment, or (iii) the creation of a physician patient or clinical relationship. If you have or suspect that you have a medical problem or that this information may be useful to you or others, please consult with your health care provider before applying any information from our articles to your personal situation or to the personal situation of others.
FAIR USE NOTICE: This may contain copyrighted (C) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a ‘fair use’ of any such copyrighted material as provided for in Title 17 U.S.C.
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