Suboxone Treatment for Veterans

Alcohol and drug abuse is a major concern in the United States. However, substance abuse among veterans is an epidemic. Opioids and alcohol, particularly, affect war veterans at a high rate. According to the U.S. Department of Veteran Affairs (VA), 1 in 10 vets treated at their medical centers after returning from Afghanistan and Iraq has problems with drug misuse. There are many disabled veterans in the U.S. Injured service members get treated for severe injuries like lost limbs, chronic headaches, and back pain. Due to the many combat-related illnesses that exist among vets, there are different opioids that doctors prescribe to treat them.

For many veterans, treatment for injuries and pain management involves opioids, only available with a doctor’s prescription. When you take them as directed, these painkillers can effectively treat various war-related injuries and ailments. However, opioids can contribute to drug abuse since they are extremely addictive. Addiction to opiate derivatives and opioid drugs is one of the most difficult addictions to overcome. While many people manage to achieve and even maintain sobriety from these medications, recovery from opioids is usually marked by depression and lingering cravings that can last for many years after you stop using them.

To lessen the gravity of opioid cravings and opioid use disorders (OUD), many doctors prescribe opioid agonists such as Suboxone for people recovering from addiction. Suboxone reduces lethal overdose rates and decreases incarceration and relapse likelihood after opioid withdrawal.

Understanding Suboxone and Its Uses

Suboxone is a prescription medicine that’s often used to treat opioid addiction. Some doctors also prescribe Suboxone as a pain relief medicine. However, you should only take this drug as prescribed by your doctor or as part of your comprehensive treatment plan. Suboxone is among the most prescribed medications in the U.S. because of the opioid crisis in the country.

In 2002, the Food and Drug Administration (FDA) approved Suboxone to treat OUD solely. The medication is available in sublingual film or tablets. It’s a part of medication-assisted treatment (MAT) programs that include behavioral therapies and psychotherapy to enhance lasting recovery. Suboxone has two active ingredients, naloxone and buprenorphine. The latter ingredient is the primary active component and is believed to be a partial agonist. That means it can easily attach to the same receptors in the brain as opioids and minimize their effects by blocking them from the receptors. Naloxone helps prevent people from misusing Suboxone by causing some withdrawal symptoms and signs upon taking the medication.

Veterans with opioid use disorders have an increased risk of overdose and suicide compared to non-veterans. A recent research study shows that the rates of overdose and suicide deaths were four times less in vets who received OUD treatment that included buprenorphine than those whose treatment did not include buprenorphine. When combined, naloxone and buprenorphine effectively deal with opioid use disorders. While buprenorphine reduces opioid cravings and withdrawal symptoms, it does not have the complete effect of opioids. Naloxone, on the other hand, blocks and reverses opioid effects. It also reverses the major symptoms of opioid overdose.

Is Suboxone Addictive?

Suboxone is a safe treatment unless you have underlying health problems. Its ingredients carry low risks of addiction. The problem with treating opioid use disorders with Suboxone is that you may still crave opioid drugs and might never stop using Suboxone. A person can abuse Suboxone by overdosing or altering the drug in ways that render naloxone ineffective. Suboxone is normally sold on the streets for a high value and has become a common drug of abuse. Although Suboxone addiction is not as harmful as opioid addiction, it can create serious problems in different aspects of your life, including your professional and personal life.

While using Suboxone for an extended period can lead to dependence on the drug, it can be an effective strategy for stopping opioid abuse. This prescription medication can produce effects similar to opioid drugs, but the high is more likely to be less severe. The best way to reduce the chances of Suboxone addiction is by going the medical-assisted treatment way when treating OUD. This option combines Suboxone use and therapy tailored to your unique needs during the recovery journey. It puts you in a safe environment of being assisted by a medical expert while taking Suboxone, reducing the probability of prolonged substance abuse.

Suboxone Use Facts and Statistics

Suboxone effectively treats opioid use disorder but is still a controlled drug. The drug can be prescribed by licensed healthcare providers in addiction treatment centers, primary care offices, and hospitals. Here are some facts and statistics about Suboxone use.

• More than 208 VA medical facilities offer naltrexone or Suboxone for acute treatment.
• Emergency room visits for non-medical use of buprenorphine were around 21,483 in 2011, almost five times more than the 2006 emergency visits.
• Suboxone sales exceeded the $1.55 billion mark in 2013.
• 6,595 war veterans received medication-assisted treatment for opioid abuse in 2020, with approximately 5,291 vets receiving Suboxone.
• 18% of facilities reported offering buprenorphine treatment services in 2010, compared to 44% in 2020.

Does Suboxone Have Side Effects?

Like many prescribed drugs, Suboxone can cause varied side effects during OUD treatment. Fortunately, most side effects aren’t life-threatening and normally subside within a few days. Some of the common side effects of this drug include:

• Fever
• Nausea
• Fatigue
• Depression
• Insomnia
• Headaches
• Sweating
• Anxiety
• Muscle pain

Can People Abuse Suboxone?

Although Suboxone is an effective treatment for OUD, it has the potential for misuse, meaning you should carefully manage its usage. The buprenorphine in the Suboxone can lead to physical dependence when taken daily for a long period. As a result, your body may become used to the drug and exhibit withdrawal effects if you discontinue the substance abruptly or reduce the dosage. The good news is that buprenorphine also has a ceiling effect, which means that its opioid constituents level off over time, even when you increase the dose. That lowers the risk of dependency, misuse, and side effects.

Although most war veterans suffering from war-related injuries and chronic pain are much older, young vets are the most vulnerable group, with opioid misuse rising among vets below 35 years of age. For instance, opioid abuse rates among young vets rose from 3% to 4.5% between 2003 and 2007″. According to different research studies, many people who abuse Suboxone do so while attempting to stop using opioids or to ease opioid withdrawal symptoms. Others misuse the drug while trying to treat psychological or physical pain. Only a few people abuse Suboxone to get high, meaning Suboxone abuse can be largely attributed to limited or lack of access to legitimate psychiatric or medical care.

A Suboxone overdose or addiction is possible if you misuse the drug. While Suboxone injections have the highest risk of overdose, all forms of Suboxone can lead to overdose when used in high doses. Since each individual is different, the causes of Suboxone overdose differ from one person to another. Because Suboxone is an opioid-created medication, overdose is among the most severe risks of Suboxone. Moreover, a Suboxone overdose can be fatal if left untreated. The common symptoms of Suboxone overdose or addiction include:

• Headaches
• Fatigue
• Chills
• Confusion
• Anxiety
• Constricted pupils
• Blurred vision
• Sweating
• Slurred speech
• Stomach pain
• Vomiting and nausea
• Loss of coordination
• Loss of consciousness

In severe cases, Suboxone overdose can lead to respiratory depression, a condition that stops or restricts breathing. This condition can induce a coma and cause serious brain damage and even death. If you or your loved one is exhibiting Suboxone overdose symptoms, call for help and avoid leaving them alone. If you have naloxone, you can administer it before help arrives.

How Suboxone Is Prescribed

Suboxone is a controlled prescription medication categorized as a Schedule III prescription drug. That means it is accepted for medical use. Although it can cause psychological or physical dependence and might be abused, the U.S. government outlines special rules indicating how practitioners should prescribe such drugs under the Drug Addiction Treatment Act.

Doctors normally prescribe Suboxone according to your stage of OUD treatment. These professionals prescribe the drug after you abstain from short-acting opioids like hydrocodone or heroin for 12 to 16 hours or after abstaining from long-acting opioids such as methadone for 30 to 48 hours. In simple terms, you should be in moderate to mild withdrawal before taking Suboxone. When starting Suboxone treatment, a large initial dose is administered to reduce withdrawal symptoms. With time, your doctor will slowly taper the dosage as the cravings and withdrawal symptoms improve. A Suboxone taper can last as short as three to five days or as long as a month or more.

Every individual has different needs when getting Suboxone treatment for opioid use disorder. Therefore, you need to work with your doctor to know which treatment plan suits you best. Although Suboxone has low to moderate potential for psychological and physical dependence, a doctor can help you monitor the prescription and usage to prevent overdose or addiction to the drug.

Is Suboxone Safe?

Suboxone is an effective and safe drug when used properly. However, it can potentially interact with other prescriptions and medications you may be taking. Using other drugs when taking Suboxone can trigger severe side effects. Before you begin Suboxone, be sure to tell your doctor about the over-the-counter drugs and prescriptions you are taking. If your doctor sees an interaction, they will work on a suitable plan to keep you healthy and safe while taking Suboxone.

Suboxone can trigger allergic reactions characterized by difficulty breathing and throat swelling when used with some medications. For instance, mixing Suboxone with other opioids such as morphine, codeine, fentanyl, heroin, and oxycodone can lead to increased overdose side effects such as sedation, respiratory depression, and even death. Mixing Suboxone with sedatives like sleeping pills and some benzodiazepines can intensify the severity of side effects like overdose, sedation, and death. Some of the most common benzodiazepine medications that worsen Suboxone side effects include Ativan, Xanax, Valium, and Klonopin. Suboxone in high doses can also induce a coma and cause liver damage.

Suboxone Treatment Coverage and Costs

The VHA (Veteran Health Administration) recommends treatment containing an opioid agonist as the preferred medication for people with opioid use disorders or those at risks of opioid withdrawal. The good news is that the VA healthcare program covers Suboxone treatment. However, your treatment coverage depends on your current military status and whether you have VA healthcare benefits.

Before you seek opioid treatment with Suboxone, visit your local VA medical center to determine the steps you need to follow to get coverage for the treatment. If you don’t have VA healthcare benefits, you might still be eligible for Suboxone treatment. Homeless veterans or those at risk of becoming homeless can also contact their local VA facility to find out how they can access treatment services.

Apart from VA, other insurance firms also cover Suboxone treatment for veterans. Such private companies include Humana, Blue Shield, Tricare, Blue Cross, and many others. Medicaid coverage policies in many U.S. states also term Suboxone as a medication of choice for OUD. However, health programs in different states provide different levels of Suboxone treatment coverage, with most states asking for prior approval for Suboxone treatment.

Suboxone treatment costs will vary depending on a veteran’s health insurance coverage, the amount of Suboxone required for treatment, and an individual’s treatment needs. Therefore, you should speak to your medical provider or VA representative to determine the cost of treatment and coverage before getting Suboxone for your OUD. While VHA allows veterans to use Suboxone to treat opioid use disorders, illegal use or misuse of Suboxone or other similar drugs can negatively affect your suitability to get disability benefits.

Final Words

Unlike other opioid alternate medications that need a prescription from a recognized specialized treatment or medical center, your doctor can prescribe Suboxone. Many people utilize Suboxone at the beginning of treatment and in ongoing treatment and recovery. If you are struggling with opioid use disorder, your addiction counselor or doctor can help you create a customized treatment plan depending on your treatment needs.

While Suboxone helps manage withdrawal symptoms from stopping opioids, finding an all-inclusive treatment program is advisable. Therapy and counseling can help you identify your underlying reasons for prolonged opioid use and discover new and effective ways to manage stress and pain. If you or a war veteran you know is struggling with opioid use disorder, contact us today. VeteransRehab.org provides mental health resources and free addiction treatment to war vets in need. Our team will also provide you with a better understanding of the VA treatment resources and programs available to you.