Suboxone and Sober Living
At Westport House sober living, we support medication-assisted treatment, including Suboxone, when indicated — always in tandem with comprehensive therapy and 12- step facilitation.
Suboxone and Sober Living: The Facts
With the nation’s premiere addiction treatment centers now treating significant percentage of patients, diagnosed with an opioid use disorder, with Suboxone (buprenorphine and naloxone) or Subutex (buprenorphine), prospective clients or family members regularly reach out to Westport House admissions to inquire about our sober living program and if they are allowed to continue taking Suboxone while residing with us. The answer, in most cases, is yes. And the reasons are clear.
Under the Fair Housing Act (FHA), it is illegal to discriminate against individuals participating in a medication-assisted treatment program. Apart from the legal aspects, we believe there is nothing inherently “wrong” with Suboxone/Subutex and sober living, and many recent studies support its efficacy (especially for individuals with a history of chronic relapse), as long as the client is taking the medication as prescribed, is under the watchful care of an addiction-trained psychiatrist, and resides in a safe, supportive environment.
Suboxone and Sober Living at Westport House
Sober living at Westport House meets all of the above criteria. We are trusted sober living resource for addiction professionals across the United States and have earned a reputation for quality sober living environments, effective services, and exceptional results. We have an integrated outpatient treatment center, dually licensed for psychiatric and substance abuse treatment by the Connecticut Dept. of Public Health and accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), staffed by experienced clinicians who specialize in the treatment of men with substance abuse and co-occurring disorders.
All medications with the potential for abuse (benzodiazepines, buprenorphine, etc.) are stored in a secure med room. Our infrastructure combined with professional staff means that we well-positioned to support an effective sober living environment combined with medication-assisted treatment.
Suboxone Maintenance vs. Suboxone Taper: We Support What Works for You
As a result, clients participating in a medication-assisted treatment program with buprenorphine can admit into the Westport House sober living program. The decision to gradually taper to zero Suboxone or simply maintain a dose that is working for you is yours alone – in consultation with our medical director – and not a 12-Step sponsor, sober living peers, family, or staff.
Should you choose a taper (once your program of recovery strengthens sufficiently, and health stabilizes), the clinical team at our outpatient center will guide you through a medically-monitored gradual taper to zero medication. In most cases, your clinician will recommend Vivitrol (an injectable form of naltrexone) injections for at least several months after your last dose of Subutex to support your sobriety.
Whether you choose maintenance or a taper, our ultimate goal is to help you live a recovery-based sober lifestyle.
Suboxone, Sober Living, & Medication-assisted treatment
Naltrexone and Sober Living
Naltrexone is an opioid blocker that is useful in the treatment of opioid use disorder and addiction. Naltrexone blocks the pain-relieving and euphoric effects of natural and synthetic opioids. This form of medication-assisted treatment does not have a risk of abuse due to a lack of addictive properties, physical dependence, and tolerance.
Buprenorphine | Subutex | Suboxone
The Food & Drug Administration approved the use of the buprenorphine (Suboxone, Subutex) for the treatment of opioid use disorder and addiction in the United States in 2002. Buprenorphine has several demonstrated advantages over naltrexone and methadone. As a medication-assisted treatment (MAT), it quells withdrawal symptoms and desire for opioids, does not cause the typical euphoria, and it blocks the effects of the other opioids for at least 24 hours. Success rates, as measured by retention in treatment programs and one-year sobriety, have been reported to be as high as 40 to 60 percent in some studies. This form of medication-assisted treatment does not require participation in a regulated program such as a methadone clinic. Since Suboxone does not cause euphoria in individuals with an opioid use disorder diagnosis and addiction, its potential for abuse is substantially lower than methadone.
What Is Medication-Assisted Treatment?
Medication-assisted treatment for opioid use disorder and addiction can include the use of buprenorphine to complement the education, therapy, 12-Step facilitation and other tools that focus on the behavioral aspects of opioid addiction. Buprenorphine can allow the individual to recover a healthy state of mind – free of cravings, withdrawal symptoms and the highs and lows of active addiction. Medication-assisted treatment for opioid addiction and misuse is similar to using medication to treat other chronic illnesses such as heart disease, asthma or diabetes. Medication-assisted treatment for opioid addiction is not the same as replacing one addictive substance for another.
What Is Suboxone and How Does it Work?
There are two medications in each dose of Suboxone. The first is buprenorphine, which is classified as a ‘partial opioid agonist,’ and the second is naloxone which is an ‘opioid antagonist’ or an opioid blocker.
What Is a Partial Opioid Agonist?
A partial opioid agonist such as buprenorphine is an opioid that produces less of an effect than a full opioid when it attaches to an opioid receptor in the brain. Heroin, morphine, hydrocodone, oxycodone, and methadone are examples of full opioid agonists. We’ll refer to buprenorphine (Suboxone) as a partial opioid and opioids like hydrocodone and morphine as full opioids.
When a partial opioid such as Suboxone is ingested, the individual may feel a slight pleasurable sensation, but most report that they feel normal or have a bit more energy during medication-assisted treatment.
People who are opioid dependent do not get a euphoric effect or feel high when they take buprenorphine as prescribed. Buprenorphine fools the brain into believing that a full opioid is attached to the receptors, and defeats withdrawal symptoms and cravings associated with opioid addiction.
Buprenorphine is a long-acting form of medicated-assisted treatment, meaning that it sticks to the opiate receptors for 24 hours or longer. When buprenorphine is attached to the receptor, the full opioids cannot get through. If an opioid is ingested within 24 hours of taking Suboxone, the patient will not feel the effect – will not get high and will not get pain relief.
Another benefit of treating opioid addiction with buprenorphine is something called the ceiling effect. The ceiling effect results in not feeling the full opioid effect when taking more than the prescribed dose. Taking extra Suboxone will not result in a “high” – a clear and distinct advantage over methadone medication-assisted treatment. Individuals can get high on methadone because it is a full opioid. The ceiling effect also helps if there is an overdose of buprenorphine– there is less suppression of breathing than from a full opioid overdose.
What Is an Opioid Antagonist and Why Is it Included in Suboxone?
An opioid antagonist such as naloxone is a medication-assisted treatment option for opioid misuse and addiction that attaches to the brain’s opioid receptors. Naloxone is not absorbed into the bloodstream to any significant degree when Suboxone is taken correctly (dissolved under the tongue). However, if a Suboxone pill or dissolvable strip is injected, the naloxone will rapidly travel to the brain and knock off the opioids attached to the receptors. This response will, in most cases, result in rapid and severe withdrawal symptoms. Naloxone has been added to Suboxone for this purpose – to discourage individuals from injecting or snorting Suboxone in pill or dissolvable strip form.
How Is Buprenorphine/Naloxone Taken As Part of Medication-Assisted Treatment?
Due to its long-acting nature (24 hours or more), Suboxone usually only needs to be taken once a day. It should dissolve under the tongue. It comes in both a 2 mg and 8 mg sublingual tablet, and a 2 mg, 4 mg, 8 mg, or 12 mg sublingual film. The film is preferred since it has less potential for abuse by individuals with an opioid addiction – it can’t be crushed, and the strip dissolves quicker than the tablet.
Individuals should not eat, drink or smoke for 30 minutes before taking Suboxone, or for 30 minutes after taking Suboxone. Food, liquids, and nicotine can block the absorption of Suboxone. Chewing tobacco can impair Suboxone absorption and should be discontinued when participating in medication-assisted treatment with Suboxone.
What Is Recovery, and How Can Family and Loved Ones Help?
Recovery is about restoring the life lost during an active opioid addiction. As a complement to medication-assisted treatment, there are many ways that family and loved ones can support the individual with an addiction. Family involvement is an important part of a program of recovery. The following are ten ways family can help:
- Learn about the disease of addiction – the biology, psychology, and sociology of addiction.
- Understanding that addiction is not about willpower or self-control.
- Understanding the hereditary components of the disease of addiction.
- Understanding the behaviors resulting from addiction, why they occur, and how they can change.
- Understanding how environments play a role in triggers, cravings and relapse.
- Learning how family members can get drawn into supporting their loved one’s addiction.
- Encouraging and motivating your loved one to attend and complete treatment even if they resist.
- Understanding that you cannot make your loved one get help, but you are not helpless. You can make changes that support recovery for your loved one, and for yourself.
- Participating in support groups that support the family of the addicts recovery (Al-Anon or Nar-Anon).
- Attending family education sessions with your loved one.
Learn more about Westport House Suboxone and Sober Living Program
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