Suboxone Addiction: Definition, Symptoms, Risk, Treatment, and Prevention

Suboxone addiction develops when individuals misuse Suboxone, a medication that combines buprenorphine and naloxone, primarily used for opioid addiction treatment. Suboxone is meant to reduce cravings and alleviate withdrawal symptoms during recovery, but when misused—such as taking higher doses or using it without medical supervision—it leads to addiction. Gavin Bart, in his 2012 article Maintenance Medication for Opiate Addiction: The Foundation of Recovery, explains that while Suboxone is effective for treating opioid addiction, misuse of buprenorphine leads to similar risks as other opioids.

The symptoms of Suboxone addiction include various physical, psychological, and behavioral changes. Physically, addiction manifests through symptoms such as nausea, drowsiness, poor coordination, and blurred vision. Psychologically, individuals experience depression, mood swings, and insomnia. Behaviorally, those struggling with addiction show signs of poor memory and difficulty focusing. Deborah Sontag, in her 2013 article “Addiction Treatment With a Dark Side”, explores how these symptoms are typical as dependency on Suboxone grows.

The causes of Suboxone addiction stem from its role in opioid dependence treatment, where individuals begin using the drug to manage withdrawal symptoms but later become dependent on it. Other factors include previous substance abuse, mental health disorders, genetics, and environmental stress. Jennifer R. Velander, in “Suboxone: Rationale, Science, Misconceptions” (2018), emphasizes the potential for misuse, especially among those with a history of opioid abuse.

Treatment for Suboxone addiction involves medical detoxification to safely wean the body off the drug, followed by behavioral therapies like cognitive-behavioral therapy (CBT) and motivational interviewing. Support groups such as Narcotics Anonymous and structured programs like outpatient treatment or partial hospitalization provide essential support during recovery. Bart highlights the importance of comprehensive care, including counseling and therapy, to ensure long-term recovery.

How to prevent Suboxone addiction involves strict adherence to prescribed doses, patient education, and monitoring. Preventive measures include regular medical follow-ups, counseling, and therapeutic support to address any underlying issues that increase the risk of misuse. Velander notes that educating patients on the risks of misuse and ensuring they understand the importance of taking Suboxone as directed is key to preventing addiction.

What Is Suboxone Addiction?

Suboxone addiction occurs when individuals misuse the medication, such as by taking higher doses than prescribed or using it without a prescription to achieve euphoric effects. Suboxone, like Bunavail, contains buprenorphine and naloxone and is prescribed to treat opioid addiction by helping to reduce cravings and manage withdrawal symptoms. Buprenorphine is a partial opioid agonist that helps reduce the effects of cravings by stimulating opioid receptors to a limited degree, while naloxone is included to block the euphoric effects if Suboxone is misused, such as through injection.

The purpose of Suboxone and similar medications like Bunavail is to allow individuals recovering from opioid addiction to stabilize by minimizing the discomfort of withdrawal and reducing the likelihood of relapse. However, when Suboxone is misused, individuals develop a dependence. Bart, in “Maintenance Medication for Opiate Addiction: The Foundation of Recovery” (2012), explains that, despite its intended medical use, the misuse of buprenorphine leads to addiction similar to other opioids, disrupting the intended recovery process.

How Common Is Suboxone Addiction?

Suboxone addiction is becoming increasingly common in the United States due to its widespread use in treating opioid use disorder. Approximately 1.5 million people in the U.S. use Suboxone or similar medications like Bunavail to manage opioid addiction. However, studies indicate that around 20-30% of these patients misuse the drug, leading to dependence and addiction. According to Bart in Maintenance Medication for Opiate Addiction: The Foundation of Recovery (2012), although Suboxone has a lower potential for abuse compared to full opioid agonists, addiction still develops when the medication is misused or taken without proper medical supervision.

What Is the Difference Between Suboxone Addiction and Suboxone Dependence?

The main difference between Suboxone addiction and Suboxone dependence lies in control and compulsion—for example, in addiction, individuals feel an overwhelming urge to use Suboxone even when it negatively affects their health or life, while in dependence, the use is typically controlled, and medically supervised. Suboxone dependence occurs when the body becomes physically reliant on the drug due to regular use, which is a common outcome of long-term treatment. In this case, stopping Suboxone suddenly would lead to withdrawal symptoms such as nausea, headaches, or irritability, as the body has adjusted to the medication.

In contrast, Suboxone addiction involves both physical and psychological reliance, where a person compulsively seeks out the drug, even using higher doses or obtaining it without a prescription to achieve euphoric effects. This compulsive behavior often persists despite negative consequences. As explained by Bart in “Maintenance Medication for Opiate Addiction” (2012), dependence is expected with proper use, but addiction develops when cravings drive misuse and the brain’s reward system is overstimulated.

What Are the Symptoms of Suboxone Addiction?

The symptoms of Suboxone addiction are physical, psychological, and behavioral in nature. Suboxone addiction typically presents itself through a combination of these symptoms, which progressively worsen over time with misuse.

The physical symptoms of Suboxone addiction include:

• Poor coordination: Difficulty maintaining balance or controlling movements, impairing daily functioning.
• Blurred vision: A lack of sharpness in eyesight, making everyday tasks such as reading or driving difficult.
• Nausea: An ongoing feeling of sickness, sometimes accompanied by vomiting.
• Drowsiness: Excessive tiredness, often leading to difficulty staying awake during normal activities.
• Poor memory: Struggles with recalling recent events or important information.

The psychological symptoms of Suboxone addiction include:

• Insomnia: Persistent trouble falling asleep or staying asleep, which leads to exhaustion and poor mental health.
• Depression: A prolonged state of sadness or hopelessness, often tied to dependency on the drug.
• Shifts in mood: Unpredictable changes in emotional states, from euphoria to irritation or anger.

The behavioral symptoms of Suboxone addiction include:

• Using the drug in higher doses than prescribed or more frequently.
• Hiding Suboxone use from family members or friends.
• Prioritizing Suboxone use over responsibilities at work, school, or home.

What Are the Withdrawal Symptoms of Suboxone?

The withdrawal symptoms of suboxone are Suboxone withdrawal symptoms include nausea, vomiting, muscle aches, sweating, chills, fatigue, anxiety, irritability, insomnia, and increased heart rate. The severity of these symptoms depends on the individual’s dependence and duration of use. According to McAuliffe et al. in their 2019 review published in the American Journal of Health-System Pharmacy, Suboxone withdrawal reflects the body’s reaction to losing the effects of buprenorphine, which typically reduces cravings and manages withdrawal symptoms. 

What Are the Causes of Suboxone Addiction?

The causes of Suboxone addiction are varied, involving both biological factors, such as a genetic predisposition to addiction where individuals inherit tendencies toward substance abuse, and environmental influences like growing up in households or communities where drug misuse is normalized. For instance, those with a family history of addiction have a higher risk, while individuals in high-stress environments or communities with widespread substance use might turn to Suboxone misuse. Suboxone addiction occurs when individuals misuse the medication, which is prescribed to help manage opioid dependence, leading to similar dependency patterns seen in other opioids. According to Ling et al. in their 2011 study published in Addiction, Suboxone, which contains buprenorphine and naloxone, is meant to reduce cravings during recovery, but misuse leads to addiction. 

The main causes of Suboxone addiction are:

• Opioid dependence treatment: Suboxone is prescribed to manage opioid withdrawal symptoms and reduce cravings. However, long-term misuse or taking it outside prescribed guidelines leads to addiction. 
• Substance abuse: Individuals with a prior history of substance abuse are more likely to misuse Suboxone, using it recreationally or alongside other drugs. As noted by Sontag in The New York Times (2013), some users divert Suboxone for non-medical purposes, increasing their risk of addiction.
• Mental health disorders: People with mental health issues, such as anxiety or depression, misuse Suboxone to self-medicate, which eventually leads to dependence. 
• Genetic factors: Those with a genetic predisposition to addiction are more susceptible to Suboxone dependency. Cicero and colleagues in JAMA Psychiatry (2014) point out that individuals with genetic risk factors have a heightened vulnerability to opioid dependence, including Suboxone.
• Environmental factors: Living in environments where drug use is prevalent or facing high levels of stress leads to Suboxone misuse. Velander in The Ochsner Journal (2018) discusses how external pressures and exposure to addiction within families or communities push individuals toward drug misuse, including Suboxone.

What Are the Side Effects of Suboxone Addiction? 

The side effects of Suboxone addiction include serious physical and mental health problems, such as dental problems like tooth decay and gum disease, primarily caused by chronic dry mouth, which is a common side effect of long-term Suboxone use. Another critical concern is liver damage, especially for individuals with pre-existing liver conditions, as Suboxone places additional strain on liver function over time. Additionally, mental health issues, including heightened anxiety, depression, and unpredictable mood swings, frequently arise, making emotional stability difficult for those addicted to Suboxone.

Furthermore, Suboxone addiction leads to severe sleeping difficulties, such as insomnia or interrupted sleep patterns, due to its effects on the central nervous system. Many users also experience urinary issues, such as painful urination or difficulty passing urine, as the drug disrupts the body’s normal chemical balance. The most dangerous side effect, however, is respiratory depression, which causes life-threatening breathing difficulties, particularly when Suboxone is combined with other depressants like alcohol or benzodiazepines.

The common side effects of Suboxone addiction include:

• Dental problems: Chronic dry mouth and its associated oral health complications. Sontag, The New York Times (2013), addresses the issue of oral health degradation in long-term users.
• Liver damage: Prolonged use or combining Suboxone with other substances contributes to liver dysfunction. 
• Mental health issues: Increased anxiety, depression, and mood swings. 
• Sleeping difficulties: Insomnia and extreme drowsiness are commonly reported, disrupting normal sleep cycles.
• Urinary issues: Suboxone misuse leads to issues with urination, affecting day-to-day functioning.
• Respiratory depression: A life-threatening condition that arises from combining Suboxone with alcohol or other depressants.

What Are the Treatments of Suboxone Addiction?

The main treatments for Suboxone addiction, such as medical detox and behavioral therapies, focus on addressing the drug’s impact on both physical dependency, such as withdrawal symptoms, and psychological factors, like emotional cravings and compulsive behaviors. Medical detox, for example, gradually reduces the drug in a controlled manner to ease the intensity of withdrawal symptoms like nausea, muscle pain, and insomnia. According to Mattick et al. in their 2014 Cochrane review, this method is important for stabilizing the body during early recovery stages. The authors emphasize that buprenorphine, the active ingredient in Suboxone, is effective in retaining people in treatment and suppressing illicit opioid use. They also note that combining medication-assisted treatment with psychosocial interventions enhances overall treatment outcomes, addressing both the physical and psychological aspects of Suboxone addiction.

Medical Detox

Medical detox helps taper off Suboxone safely by managing the physical symptoms of withdrawal while preparing the individual for further psychological treatment. Along with detox, cognitive-behavioral therapy (CBT) helps individuals recognize and modify thought patterns and behaviors that fuel addiction. 

Behavioral Therapies

Behavioral therapies like CBT target the psychological aspects of addiction, helping patients address compulsive thoughts and emotional triggers that lead to relapse. Additionally, motivational interviewing enhances patients’ commitment to recovery by encouraging them to reflect on their personal goals and motivations for staying sober.

Support Group

Support groups, such as Narcotics Anonymous, offer peer support, which fosters accountability and emotional connection by allowing individuals to share their experiences, reinforcing their recovery journey.

Intensive Outpatient Program (IOP)

Intensive Outpatient Programs (IOP) combine frequent therapy sessions with the flexibility of living at home, helping individuals manage both their addiction treatment and daily responsibilities. 

Partial Hospitalization Program (PHP)

Partial Hospitalization Programs (PHP) provide more structured daily treatment for those needing intensive care, allowing individuals to receive psychological support while maintaining some independence. Jones, in the New England Journal of Medicine (2012), explains that this method is particularly beneficial for those requiring intensive psychological care without full-time hospitalization.

How to Prevent Suboxone Addiction?

To prevent Suboxone addiction, strict adherence to prescribed medical protocols is essential, along with comprehensive education on the risks of misuse. Ensuring patients are aware that misuse leads to both physical dependence and psychological reliance is essential. For example, medical professionals must emphasize that even though Suboxone helps manage opioid withdrawal, increasing the dosage without guidance results in addiction due to its effects on the brain’s reward system. Velander, 2018, in The Ochsner Journal, highlights that combining Suboxone treatment with behavioral therapies such as Cognitive Behavioral Therapy (CBT) or motivational interviewing significantly reduces the risk of addiction.

In addition, regular monitoring, including drug screenings and counseling sessions, helps manage and reduce cravings, ensuring that Suboxone is used strictly for recovery and not abused. Educating patients about the dangers of combining Suboxone with substances like alcohol or benzodiazepines is another important strategy to mitigate the risk of overdose or intensified addiction.

Can You Overdose on Suboxone?

Yes, overdosing on Suboxone is possible, especially when mixed with substances like alcohol or benzodiazepines. Suboxone contains buprenorphine, which is designed to help reduce cravings, and naloxone to prevent misuse. However, combining Suboxone with alcohol or benzodiazepines slows or stops breathing due to their combined sedative effects, leading to a fatal overdose. According to Jones et al. in their 2020 study published in Drug and Alcohol Dependence, buprenorphine was involved in 2,385 overdose deaths in the United States in 2018, with 87% of these deaths also involving other substances. The authors explain that the sedative properties of Suboxone, when combined with other depressants, result in respiratory failure, which is the primary cause of overdose death in these cases.

How Does Suboxone Addiction Affect Daily Life?

Suboxone addiction affects daily life by impairing both physical and psychological functioning, reducing motor coordination and energy levels. According to Weiss et al. in their 2011 study published in the Archives of General Psychiatry, addiction leads to symptoms like drowsiness and difficulty focusing, which disrupt daily tasks and work performance. In their study of 653 prescription opioid-dependent patients, 49% reported impairment in physical health, 64% in mental health, and 78% in overall quality of life due to their opioid use. Psychologically, individuals experience mood swings, depression, and anxiety, further complicating emotional stability and contributing to stress in personal relationships.

Additionally, Suboxone addiction negatively impacts professional and social life. As highlighted by Deborah Sontag in her 2013 investigation for The New York Times, those struggling with addiction often suffer from reduced productivity due to cravings and withdrawal symptoms. This addiction causes them to miss work obligations and damages relationships, as erratic behaviors erode trust and caus

Is Suboxone Safe While Pregnant?

Yes, Suboxone can be used during pregnancy, but it should be closely monitored by healthcare professionals to minimize risks to both the mother and the baby. Suboxone, which contains buprenorphine and naloxone, is often preferred over methadone because it has a lower risk of causing severe withdrawal symptoms in newborns. However, the baby might still experience Neonatal Abstinence Syndrome (NAS), which includes symptoms such as irritability, poor feeding, and tremors after birth, as explained by Jones and colleagues in the New England Journal of Medicine (2012).

While Suboxone is considered safer than other opioid treatments during pregnancy, it is essential to carefully manage the dosage and monitor the mother’s health to prevent complications. The risks of untreated opioid addiction, such as preterm birth, low birth weight, and stillbirth, outweigh the potential risks associated with Suboxone when used under medical supervision. Proper prenatal care and addiction treatment are critical to achieving the best outcomes for both the mother and the baby.

What Is the Recommended Dosage of Suboxone for Opioid Addiction? 

The recommended dosage of Suboxone for opioid addiction is typically initiated with 2 to 4 mg of buprenorphine and naloxone, with adjustments made depending on the individual’s response and withdrawal symptoms. During the induction phase, patients are usually monitored closely by healthcare providers to ensure the dosage is effectively managing cravings and withdrawal. According to Velander in The Ochsner Journal (2018), the dose is gradually increased up to 16 mg per day for maintenance, depending on the severity of the addiction and the patient’s needs.

Most patients will remain on Suboxone as part of a comprehensive treatment plan that includes counseling and behavioral therapies. It’s important for the dosage to be tailored to the individual, as higher doses are required for long-term opioid dependence, while others stabilize on lower doses.