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January 15th, 2010 
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SUBOXONE® for the Treatment of Opiate Addiction
This article offers a brief look at the use of buprenorphine (Suboxone®)
for the withdrawal and detox of opiates, including:
- heroin
- methadone
- vicodin
- lortab
- oxycontin
- prescription opiates
- street (illicit) opiates
Clients who have experienced the most success using Suboxone for heroin and other opiate addictions are usually individuals who have been previously and objectively diagnosed as being addicted to opiates. They are are willing to follow safety precautions for treatment, are expected to comply with the treatment, and agree to buprenorphine treatment after going over treatment options.
There are four phases of Suboxone® therapy. The phases are: Induction, Stabilization, Titration and Treatment.
INDUCTION
This phase is the medically monitored startup of buprenorphine therapy. Buprenorphine for induction therapy is administered when an opiate-dependent individual has abstained from using heroin or other opiates for 12-24 hours and is in the early stages of opiate withdrawal or detoxification. If the patient is not in the early stages of detoxification, i.e., if he or she has other opioids in the bloodstream, then the buprenorphine dose could cause acute withdrawal.
Induction is typically initiated as observed therapy in the physician’s office and is carried out using Suboxone®.
STABILIZATION
This phase begins when the client has completely stopped using his or her drug of abuse, cravings are no longer occurring, and the client is experiencing very few or no withdrawal symptoms. The dosage of buprenorphine is generally adjusted during the stabilization phase. And, because of buprenorphines long half-life it is sometimes possible to switch clients to alternate-day dosing; but only once stabilization has been achieved.
TITRATION
The titration phase begins once the client is comfortable, unaffected by cravings and generally doing well on a steady dose of Suboxone®. As the client continues to show no signs of opiate withdrawal, titration begins. The client is slowly and methodically “stepped-down” from the buprenorphine therapy, until he or she is drug-free. This phase replaces what was known commonly as “detoxification”.
TREATMENT
All of an individual’s medical and psychosocial co-morbidities need to be addressed comprehensively for the treatment of heroin, methadone or other opiates to truly be effective. Medication or drug replacement therapies rarely achieve long-term success by themselves. Suboxone® or any pharmalogical therapy needs to be combined with concurrent behavioral therapy. In fact, this point is considered so important that doctors who take the tests in order to prescribe Suboxone must also state that they have the ability and the means with which to refer clients to additional addiction treatment and counseling.
(Substance Abuse and Mental Health Services Administration).
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