Quite simply, it is to prevent people from crushing the tablets and injecting them. What this means is that once the molecule is attached to a receptor site on the brain, it does not activate or light up that receptor to the same extent most other opioids do, including methadone.
You can think of it like a light switch. Where methadone is like turning the light on, Suboxone is like a dimmer switch. Once attached to the receptor, it does not like to come off. This is one of the reasons it so long acting. So what does this have to do with precipitating withdrawal?
Well, if an individual who takes Suboxone for the first time also has recently taken any other opioid, the Suboxone will be forced to compete with that other opioid for the receptor. This alone does not cause the precipitated withdrawal. This is what causes the withdrawal. Bottom line, If you are planning on going onto Suboxone, it is very important that you present for the first dose in a state of mild to moderate withdrawal.
If you get the first dose while actively using other opiates, it was cause a severe withdrawal that is difficult to reverse for hours. In general, most short acting opioids like heroin, morphine, oxycodone result in withdrawal symptoms starting about 6 hours after consumption.
Long acting opioids like methadone, Oxycontin, etc take much longer to leave the system. So, the question really comes down to how soon the individual feels mild to moderate symptoms kick in. These symptoms included yawning, sneezing, slight nausea, slight muscle cramping. They should not be severe symptoms such as vomiting and diarrhea.
Once a person has established how soon withdrawal symptoms kick in for their last use, adding on a few more hours usually does the trick. In general, for short acting opioids, most people should present in the morning, not having used anything else, including codeine, from at least the night before. If your doctor told you to use more than 1 film, place the second film inside your other cheek. Do not place more than 2 films inside of 1 cheek at a time.
Do not move or touch the film. Do not eat or drink anything until the film is completely dissolved. Sublingual tablet: Place the tablet under your tongue. If your doctor told you to use more than 1 tablet, place all of the tablets in different places under your tongue at the same time.
You can use 2 tablets at a time until you have taken all of the medicine, if that is easier for you. Let the tablets dissolve completely in your mouth. Do not eat or drink anything until the tablets are completely dissolved. Sublingual film: Drink some water to help moisten your mouth. Place the film under your tongue. If your doctor told you to use more than 1 film, place the second film on the opposite side from the first one. Do not move the film after you placed it under your tongue.
If you are supposed to use more than 2 films, use them the same way, but do not start until the first 2 films are completely dissolved. Do not break, crush, chew, or cut the film or tablet.
This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one. Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
Ask your pharmacist about the best way to dispose of medicine you do not use. Call your doctor for medical advice about side effects.
Call your doctor right away if you notice any of these side effects: Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing Blue lips, fingernails, or skin Changes in skin color, dark freckles Cold feeling, weakness or tiredness, weight loss Dark urine or pale stools, nausea, vomiting, loss of appetite, stomach pain, yellow skin or eyes Extreme dizziness or weakness, shallow breathing, sweating, seizures, cold or clammy skin Severe confusion, lightheadedness, dizziness, or fainting Trouble breathing or slow breathing If you notice these less serious side effects, talk with your doctor: Constipation or upset stomach Headache, trouble sleeping Shaking, runny nose, watery eyes, diarrhea, muscle aches.
Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease including hepatitis , lung or breathing problems, adrenal gland problems, an enlarged prostate, trouble urinating, gallbladder problems, thyroid problems, stomach problems, or a history of depression, brain tumor, head injury, alcohol or drug abuse. This medicine may cause the following problems: High risk of overdose, which can lead to death Respiratory depression serious breathing problem that can be life-threatening Adrenal gland problems Liver problems Serotonin syndrome, when used with certain medicines This medicine may make you dizzy or drowsy.
Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy. Tell any doctor or dentist who treats you that you are using this medicine. This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working. Do not stop using this medicine suddenly.
Your doctor will need to slowly decrease your dose before you stop it completely.
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