Is Suboxone a Reasonable Treatment Option for Opioid Addicts?
After twenty years of providing substance abuse treatment I can tell you that the ultimate goal
of anyone battling an addiction is total abstinence. Every addict and alcoholic eventually
figures out they can not control their usage, and moderation is unrealistic. Learning to live life
on life’s terms is part of the process of learning to live abstinent. Self-help programs like
Alcoholics Anonymous(AA) and Narcotics Anonymous(NA) do a great job of helping people
understand their addiction, themselves, and effective solutions for coping with their disease.
I’ve truly never seen anything work better, and when it works it’s a beautiful thing.
Dead people don’t get into recovery
Opioid addicts are not terribly different from any other addict or alcoholic, except the risk of
death by accidental overdose is huge. People are dying in droves from opioid overdose. The
current heroin epidemic is even more dangerous than the pain killer epidemic it replaced.
Relapse rates are tremendous. Unfortunately, it may take years before an individual addict is
ready to give the 12-Step AA/NA process the thorough try it requires to be effective. Therefore,
Suboxone is a terrific option for chronic relapsers. You can't generally get high from it, unless
you haven’t used in awhile, or never used in the first place. You can't overdose on it from use
or abuse, and any other opioid you take while it’s in your system will be nullified and wasted.
The Subs knock down the monster cravings almost completely, and people don't go through the
nasty withdrawal that’s so painful. Once dysfunctional people who couldn’t hold a job, or were
constantly on the obsessive hunt for the next fix suddenly become much more functional, and
the addiction looks like it’s in remission. They can work consistently, they stop chasing the
drugs, they have more money and can care for themselves and their families, and their
addiction doesn’t seem to be ruling their lives. It seems like magic!
Very few people actually wean off Suboxone successfully
Suboxone users often wrongly think they're cured because they look and feel more functional.
Then they think all they have to do now is wean down, or taper off the medication, which is
what the clinic doctors help them manage over a number of months to years. The problem is
they've done nothing about the underlying addiction and all the addictive thinking and coping
that go along with it that drive the addiction from within. They haven’t developed any social
support, or learned anything about themselves and their disease. We like to say that using, or
putting some chemical into the body, is only a symptom of the underlying disease. Abusing
substances is not the actual disease—just a symptom. As soon as they stop using the Subs the
addiction is still there and ready to start expressing itself all over again through the many
painful ways it does. Chemically addicted people cope with life stressors with chemicals—that
is, unless they make some fairly significant changes. Suboxone changes nothing in the end.
Suboxone changes nothing
A combination of Suboxone treatment coupled with AA/NA (with Sponsor and Step work) is a great thing. At Crossroads Counseling we require anyone with a substance abuse issue to attend AA/NA, obtain a Sponsor, and work the 12-steps. If they don’t we won't sign-off on their program. Most Suboxone clinics require their participants to attend at least one counseling meeting a month. Unfortunately, this is almost completely useless unless the individual engages in a personal program of recovery that addresses not only the biological issues, but the social, psychological, and spiritual issues related to the disease, as well.
Not the solution, but maybe a good step forward
Suboxone is not the solution, but in many cases it’s better than nothing, and a good response for chronic relapsers who are risking death from overdose. At least the addict is getting some exposure to treatment which is more likely to lead to recovery in the long run. Suboxone buys people time and keeps them alive. There are quite a few people who’s funerals I’ve attended that I wish had gotten on Suboxone. You can’t treat the dead.