Am I switching one addiction for another?

No– You are switching an addiction for a physical dependence. A physical dependence is not a medical condition that requires treatment. Addiction is! Addiction is damaging. Dependence is an inconvenience but is normal physiology for anyone taking large doses of opioids for an extended period of time. It is the direct result of the body's increased tolerance to the opioid.

To understand why, you must be clear on the definition of addiction and know how it differs from physical dependence or tolerance.

The American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, recognizes these definitions below as the current accepted definitions.

I. Addiction:
Addiction is a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.

II. Physical Dependence:
Physical dependence is a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist.

III. Tolerance:
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.

Physical dependence and tolerance are normal physiology. Addiction is a disorder that is damaging and requires treatment.

When a patient switches from an addictive opioid to buprenorphine, the addictive behavior often stops. In part to the long half-life, patients do not have physical cravings prior to taking their daily dose. The drug seeking behavior ends. Patients regain control over drug use, compulsive use ends, they are no longer using despite harm, and many patients report no cravings. Thus all of the hallmarks of addiction disappear with buprenorphine treatment.

Therefore, one is not trading one addiction for another. They have traded a life risking situation (addiction) for a daily inconvenience of needing to take a pill (physical dependence), as some would a vitamin. Yes they still have a physical dependence, but that is vast improvement over addiction and it can be managed medically.

Reference: http://www.NAABT.org

Published by: Dee Black, Moderator

Bullldog,
The dosage for the Suboxone will depend on your body. But as far as building up a tolerance for it, I would have to say from my experience " No. " Suboxone is not like any other medication that I know of. It is not like methadone, which by the way is a wonderful medication, but more for people that have severe chronic pain along with their addiction.
When I was started on Suboxone I was at a Residential Treatment Facility. The reason for that was because before I was put on Suboxone I was on Methadone for 4 years. Then I moved to a different state, and the state that I live in now only has a tiny handful of methadone clinics, and the closest one was 1 1/2 hours away from me, I don't have a vehicle. So my only other choice was to switch. I went cold turkey off of methadone for about a month, but I couldn't stand the withdrawal so I checked into an Inpatient Rehabilitation Facility. I was first put on Subutex for a couple of days, then they changed me over to Suboxone.
When I got out, my doctor put me on 12mg of suboxone but I was still having cravings, so at my next appointment one week later she put me on 16mg a day. I have been on 16mg for 2 1/2 years now. I don't have any cravings at all. I have no desire to up my dose. Some days I even take less than the 16mg.
You will find out that with Suboxone " Less is More" meaning the less you take AFTER your stabilization period the better you will feel. Also one of the side effects of the Suboxone is a headache. The naloxone in the Suboxone can cause you to have headaches is you take too much of it. You can go up to 32mg. But that is not done very often. I wouldn't do it unless you talk to your doctor about it first.
Remember one thing... Suboxone is supposed to do two things...

1. Stop your cravings.
2. Eliminate withdrawals.

If you have either one of these call your doctor and let him/her know so that they can adjust your dose. I'm sorry If I seem to ramble on, but I want to make sure that I cover everything before your appointment, so that you will know what to expect. If you have any more questions, let me know.
Yours,
Dee Black, Moderator

Check out the URL on our Suboxone Website. It will give you an idea of what to expect on your first visit.