Four Promising Alternatives to Suboxone for Overcoming Opioid Dependence

Opioid was prescribed legally as a painkiller in the US in the 1990s. However, the issue has become more severe in the past decades because of the increased availability of inexpensive synthetic opioids from foreign markets.

More than a million people have died in the past two decades due to drug overdoses, the majority of which were due to opioids. The crisis is so grave that there are more than 1,500 deaths every week due to opioid overdoses.

Approved by the US Food and Drug Administration (FDA) in 2002 for treating opioid dependence, Suboxone rose to fame in no time. It was very effective in mitigating relapse tendencies in people wanting to quit opioids.

In recent years, however, its adverse effects have impeded its ascent. A growing proportion of individuals who used Suboxone have documented experiencing severe complications from extended usage of Suboxone films. This necessitated alternative solutions that did not have life-changing side effects.

This blog post delves into four promising alternatives to Suboxone, offering hope and new pathways for overcoming opioid dependence.

Overview of Suboxone Controversy

Suboxone is generally prescribed as pills or a dissolvable film. The user can just keep the film on the underside of the cheek. According to TruLaw, it dissolves in the mouth, and the ingredients take approximately 20 to 45 minutes to take effect.

The acidic nature of the film and the fact that it gets directly absorbed in the mouth have caused severe dental issues in consumers. Crown erosion, tooth loss, tooth decay, and root canals are some side effects highlighted in the users’ outcries.

The drug was initially produced and marketed by the manufacturers as a safe medication. However, many affected are now suing the companies involved in its production and marketing for underplaying the risks of the drug.

According to Drugwatch, as of May 2024, over 200 Suboxone lawsuits are pending in multidistrict litigation within the Northern District of Ohio.

In addition to the dental complications mentioned in the Suboxone lawsuit, teeth decay cases also cause a lot of psychological trauma. Imagine a receptionist whose work requires her to greet everyone with an ear-to-ear smile. Now, she has lost three of her front teeth due to Suboxone use.

Do you think that her self-esteem as a receptionist will not take a hit? There is a high chance of her losing her job and going through mental trauma. Moreover, for many, their social life can come to an abrupt halt if they become conscious of their appearance.

Lofexidine: A Non-Opioid Alternative

This drug was approved by the FDA in 2018. Unlike Suboxone, it attacks the root cause of opioid withdrawal distress—the body’s stress response system.

The initial few weeks of abstaining from the narcotic can be very painful, with excruciating withdrawal symptoms like grave anxiety and gastrointestinal issues. It is specifically during this phase that lofexidine comes into action.

Norepinephrine is a neurotransmitter that plays a big role in the body’s stress response. Essentially, Lofexidine tempers the surge of norepinephrine, bringing distressing symptoms under some control. People who are on this medication have very low relapse tendencies.

However, according to the Mayo Clinic, this drug does come with a few mild side effects like mood swings, anxiety, trouble sleeping, and dry mouth.

Brixadi: Extended Release Mechanism

Brixadi is one of the most recent drugs approved by the FDA in 2023. It comes in two forms: weekly and monthly. In both cases, the drug is administered subcutaneously for a steady, controlled release of buprenorphine for an entire week or even a month.

Here, the consumer does not need recurring injection shots or pills. Hence, this process provides a great chance for people with OUD to sustain long-term recovery. Moreover, the gradual release mechanism goes a long way in reducing the risk of withdrawal symptoms and cravings.

Many OUD survivors prefer this mode of treatment because it saves them from repeated clinic visits and offers them privacy and convenience. This increased accessibility and acceptability can motivate more people to seek assistance.

Only about 5% or fewer cases have reported adverse effects with the use of Brixadi. Some of these include nausea, injection-site erythema, puncture wounds, and constipation.

Methadone Maintenance Therapy (MMT): Long Lasting Treatment

Methadone itself is an opioid and an opioid agonist. However, its use is very different from heroin or other synthetic opioids; it is delivered in a strictly controlled environment and customized for each patient.

Methadone treatment has been recognized by the World Health Organization(WHO) as an Essential Medicine and has been in use since the 1950s. The patient takes a daily dose of methadone either in liquid or pill form, often exceeding 60mg per dose.

This long-lasting treatment aims to find a sweet spot that effectively suppresses cravings without inducing euphoria. It has been found that MMT under supervision helps alleviate withdrawal symptoms and reduce cravings for opioids. Moreover, since it does not involve injecting for abuse, like in the case of heroin, it helps mitigate the incidence of HIV in rampant users.

However, MMT isn’t a one-size-fits-all approach. It demands a commitment to regular clinic visits, adherence to program rules, and a desire to tackle the root causes of dependence.

Behavioral Therapies: The Non-Pharma Angle

This model works with the root cause of overuse—the science behind habit formation. It comprises three main stages: receiving the cue, doing the habit, and the reward system. The cue or trigger for any habit might not always be in our control.

Say, for example, that stress triggers someone’s opioid use. Now, the causes of stress can be many. We cannot control the stimulus. So, the therapy does not tinker with the cue. What it does, is that it changes the action. This is done so that the resulting reward feels the same.

Now, instead of reaching out to an opioid (that rewards the person with euphoria), the individual can choose to eat dark chocolate, which also induces euphoria. Cognitive behavioral therapy has been a game changer in this regard.

CBT allows and guides patients to be mindful and reflect on the distorted thoughts and beliefs that trigger cravings. Patients learn to recognize and fight the mental traps that keep them stuck in the cycle of addiction through hands-on activities and guided self-reflection.

To sum up, the opioid crisis is a grave reality that needs our attention at the earliest. Suboxone did come as a beacon of hope, but the side effects were too widespread for it to be considered as a viable solution.

We have a lot of opioid-dependent, opioid-free, and non-pharmaceutical solutions at our disposal. However, treatment options vary from person to person.

You should also resort to resources and platforms like the National Institute on Drug Abuse (NIDA), Substance Abuse and Mental Health Services Administration (SAMHSA), and the Jed Foundation. Stay close to your support systems, be it family, friends, or your doctor. Talk to them openly about your feelings and cravings.

Also Read: Your Ultimate Destination

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