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What Are The Long-Term Benefits Of Suboxone (Buprenorphine) Treatment?

When you think of buprenorphine (Suboxone) treatment for opioid addiction, what comes to mind?

If you think of it as a detox aid, intended to help decrease the discomforts associated with withdrawal from heroin and other opioids of abuse, don’t feel bad. This is a common misconception—one that many people spread. Although buprenorphine can certainly be used as a detoxification aid, that’s not actually it’s most functional purpose. In fact, buprenorphine (usually combined with naloxone to prevent misuse of the drug) is best used as a long-term treatment for opioid addiction recovery.

How Opioids Change The Brain

If you or someone you love has been affected by opioid addiction, you’re probably already aware that addiction causes changes in the brain. Opiates in particular create a physical dependency alongside a psychological addiction, making them especially difficult to stop using. Drugs like heroin and prescription pain pills like oxycodone latch onto our natural opioid receptors, which are integral to many bodily functions such as our pain and pleasure responses, sleep regulation—even breathing. Normally, our brain creates natural opioids, but when we become habituated to external opiate drugs, our bodies stop producing them at the normal rate, leading to a host of issues that manifest as acute withdrawal and can linger as post-acute withdrawal syndrome (PAWS). Replacement therapies correct some of those changes, helping the brain re-calibrate after addiction.

Methadone has been the gold standard opioid replacement therapy for decades, but buprenorphine has gained popularity in the past few years. Because it is a partial-opioid agonist, rather than a full agonist like methadone, it is less likely to cause fatigue and will be easier to taper from. Some rehab facilities taper patients from heroin or other short-acting opiates using decreasing doses of buprenorphine. Hence, the notion that buprenorphine is a “detox drug.”

Patient Outcome For Long-Term Buprenorphine Use

Patients who use buprenorphine for six months or longer tend to have better outcomes than patients who use it only as a detox aid. While abstinence after detoxification is thought to have a relapse rate that can broach 90%, 60 to 90% of patients undergoing buprenorphine maintenance for a year or longer will remain in treatment. The same study even found that those patients who remained in treatment also had better measures of overall health, such as increased social function, and lower viral load in HIV positive patients.

Virtually all of the studies measuring the effectiveness of buprenorphine for long term use mention a need for additional psycho-social interventions. Addiction is considered a chronic relapsing brain disease. Those who challenge that definition still recognize that it is at least a psychological condition. Addiction likely has a genetic component, and it definitely causes changes in the brain. But environmental factors also play their part. At the very least, an opioid addiction will never be triggered in a body that has never been introduced to opiates. We also know that trauma and mental illness may play a role. For example, post-traumatic stress disorder is thought to be three times higher in patients with substance use disorders than the general population. This means that while medication-assisted therapy can help with the biological component of addiction, psychological interventions are also important.