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Issue Date: March 2007


Top Docs Suboxone Therapy

“In the early stages of sobriety, people slip up,” says  Dr. Theodore V. Parran, associate medical director of Rosary Hall at St. Vincent Charity Hospital. Now, there’s help — in the form of a hexagonal, orange-flavored pill — for an opioid addict’s moments of
weakness.
The tablet, called Suboxone, is placed under the tongue, and, in conjunction with dependence counseling, can help addicts relieve their opioid cravings and withdrawal symptoms. Suboxone is the only FDA-approved medication for treatment of opioid dependence in an office-based setting.
Its main ingredient, a drug called buprenorphine, binds tightly to the “Mu” receptors — so-named for the first letter of mor-phine — and acts like an occupied parking space in the brain that blocks heroin or painkillers from latching on and taking effect. (This means Suboxone works even if patients use heroin or painkillers in addition to taking the medication.)
Suboxone doesn’t activate Mu receptors to the same degree as the actual drugs, so users can’t become addicted. Also, the helpful drug comes off the receptors slowly (called “slow dissociation”), making it easier for patients to withdraw from Suboxone.

“The brain craves drugs so strongly, the drop-off rate in treatment is high,” says Parran, who uses Suboxone in his practice. Suboxone greatly reduces or eliminates patients’ drug cravings when used as directed, he says, and patients are three times more likely to achieve uninterrupted sobriety by taking the medication.            

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