Additional Resources

America’s overdose epidemic has been characterized as 4 distinct and interrelated epidemics: prescription opioids, heroin, fentanyl and fentanyl analogues, and stimulants. Even though physicians have decreased prescribing of opioid analgesics, America’s patients are currently facing a drug overdose – both fatal and non-fatal – epidemic that is fueled by illicit drugs, including counterfeit fentanyl and fentanyl analogues, psychostimulants, heroin, cocaine, and drug combinations.

1. Suboxone and Pregnancy: Buprenorphine-naloxone is a commonly used maintenance medication for nonpregnant patients with opioid dependence. It has been demonstrated to be a safe and effective opioid agonist in outpatient and primary care settings. Recent evidence shows buprenorphine to be equivalent or superior to methadone in managing opioid dependence in pregnancy. Studies found that, within the context of an established prenatal program that values opioid tapering to decrease NAS, (neonatal abstinence syndrome) buprenorphine-naloxone can be safely used in pregnancy. Studies also found that pregnancies exposed to buprenorphine-naloxone had significantly larger (normal) birth weights than pregnancies exposed to other narcotics did (P = .004), and more patients taking buprenorphine naloxone were able to cease illicit opioid use in pregnancy.

2. Suboxone and its mechanism of action: Suboxone contains four parts buprenorphine and one part naloxone. Buprenorphine works by tricking the brain
into thinking that it is receiving a full dose of an opioid, while naloxone blocks the activation of opioid receptors, thereby reversing the euphoric effects of buprenorphine. Opioid receptors are found in the brain, and they consist of opioid substances naturally produced in the body. Opioid receptor activation results in feelings of reward and pleasure.

3. Suboxone and the risk of overdose: Suboxone has a lower overdose potential because it produces a “ceiling effect.” This is a pharmacological phenomenon in which the impact of the drug on the body plateaus. This means that once you reach the therapeutic limit of Suboxone, taking more than its intended dosage (24-32 mg) per day will no longer yield a euphoric effect—and only potential side effects.

4. Suboxone and the risk of addiction and overdosing: Despite the life-saving benefits of Suboxone, one thing worth keeping in mind is that it is an opioid in itself, so if it’s taken at too high of a dose, without prescription, or in any other way than intended on the label, it can still put you at risk for addiction and overdose. Given Suboxone ceiling effect, some people resort to injecting the drug, thereby bypassing its time-release qualities and making overdose much more likely.

5. How is Suboxone given: The first is the induction phase, in which you undergo an intake assessment to determine the proper dose. The second step is the stabilization phase, in which you receive counseling and support services to confront the underlying cause of your addiction. The third step is the maintenance phase, in which you continue to take the correct dose of Suboxone while beginning to return to a normal lifestyle. The last step is the taper phase, in which your mental health provider will gradually reduce the required dose of Suboxone until you no longer need it.

What Are Opioids?
Opioids are drugs used for pain relief, including prescription medications like oxycodone, hydrocodone, and morphine, as well as illegal substances like heroin. Both types can be highly addictive.

How Does Opioid Addiction Develop?
Opioid addiction often starts with a prescription for pain management. Over time, tolerance builds, leading to higher doses, physical dependence, and potential addiction. Misuse for euphoria can also increase addiction risk. Signs and Symptoms of Opioid Addiction

• Cravings: Intense urges to use opioids
• Increased Tolerance: Needing more opioids to feel the same effect
• Withdrawal Symptoms: Nausea, sweating, shaking, anxiety when not using
• Neglecting Responsibilities: Failing to meet personal or work obligations
• Social Withdrawal: Avoiding activities or people not using opioids
• Financial Problems: Spending excessive money on opioids

Physical and Mental Health Impacts
Opioid addiction can cause respiratory problems, infections, and overdose. It also leads to depression, anxiety, and cognitive issues, significantly affecting quality of life.

The Role of a Licensed Addiction Provider
Licensed addiction therapists provide counseling, help uncover the root causes of addiction, offer coping strategies, and guide treatment options to support recovery. Treatment Options for Opioid Addiction:

• Medication-Assisted Treatment (MAT): Combines medications with counseling to reduce cravings and withdrawl.
• Behavioral Therapies: Change unhealthy thinking patterns and teach coping skills.
• Inpatient Rehabilitation: A structured environment focused on recovery with medical care and therapy.
• Outpatient Programs: Flexible treatment while living at home.
• Support Groups: Community-based emotional support and sobriety tips.

Preventing Opioid Addiction

• Education: Inform the public on risks and safe medication practices.
• Proper Prescription Practices: Healthcare providers should monitor opioid use.
• Alternative Pain Management: Use non-opioid therapies like physical therapy or acupuncture.
• Disposal of Unused Medications: Safely discard unused opioids.

The Stigma Surrounding Opioid Addiction
Opioid addiction is a medical condition, not a moral failing. Reducing stigma involves educating the public, promoting empathy, and supporting policies for better resources.

Recovery and Relapse Prevention
Recovery from opioid addiction is ongoing and requires continuous support. Relapse is common but should be seen as an opportunity to strengthen recovery plans, with help from loved ones and professionals.

Opioid addiction is challenging, but recovery is possible with the right treatment and support. Recognizing addiction, understanding treatment options, and seeking professional help can help individuals reclaim their lives. Education, empathy, and ongoing support are key to overcoming the opioid crisis.