WISE Medical Centers, LLC

FAQS: Opiod Dependence

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Opioid dependence—addiction to opioids such as prescription painkillers like oxycodone, hydrocodone, or heroin—is a challenging and complicated condition. But it can be treated effectively with medication-assisted treatment combined with counseling and support.  If pain medications are ruining your life or affecting your family or threatening your job or business—it is past time to get help getting off of them!

 Learning about opioid dependence and taking action can have a real impact on your life.       Start here:

WISE Medical Center is a place where we can discreetly get help with your efforts to deal with the difficulties associated with pain meds.  Ask our staff about help with dose adjustment or out patient detox etc.


 Q. What are opioids?

 A. Opioids are drugs that work in the body the way opium does. (for example, the painkillers oxycodone, hydrocodone, and fentanyl, better known by such brand names as OxyContin®, Vicodin®, Percocet®, and Actiq®*) and tramadol. The illegal drug heroin is also an opioid.  All of these drugs are similar in their actions and consequences

 All of these drugs are extremely powerful. For people with severe pain, opioids are very effective medicines, and most patients treated for pain with opioids do not become dependent on them. For some people, however, opioid dependence is an unexpected side effect of proper pain treatment.  Addiction happens to good people.  Not all addicts are recreational abusers.  Problems arise when someone is unable to stop using the drug after the cause of the pain has resolved.


Q.  Do you use medications to help with withdrawal symptoms while detoxing off of opiods?

 A. Yes, usually.  There is no single correct way detox off opiods.  Sometimes sedatives, anti-nausea, even antidepressants and blood pressure medications are helpful in different stages of this process.  Some patients have to be tapered gradually over weeks or even months before the actual detox process starts.  One of the most useful techniques involves Suboxone.  (Active ingredient buprenorphine.)   Buprenorphine is started once withdrawal has begun. Another drug Naltrexone cannot be taken until opioids are completely out of the body, usually 7 to 10 days after withdrawal begins.  Naltrexone works as a deterrent to discourage resuming use of opiods.


Q.  What is the difference between tolerance, physical dependence and addiction?

It can be difficult to know the difference between tolerance, physical dependence and addiction. Tolerance refers to the situation in which a drug becomes less effective over time. Physical Dependence means that a person will develop symptoms and signs of withdrawal (e.g., sweating, rapid heart rate, nausea, diarrhea, goosebumps, anxiety) if the drug is suddenly stopped or the dose is lowered too quickly.  Addiction refers to a condition when a person has lost control over use of the drug and continues to use it even when the drug is doing harm to themselves or others.  People who are addicted engage in unacceptable behaviors like obtaining pain medications from non-medical sources or altering oral formulations of prescription medications or snorting or inappropriately injecting medications.  Particularly when you have a past or current history or even family history of substance abuse, the chance of addiction is significant when pain medications are prescribed by a doctor even when taken as directed. Ask your provider what you should watch for when taking potentially addictive prescription medications.

For more info about out patient treatment of addiction:

Specific Questions about Suboxone: (See also: Understanding Suboxone)

 1.  If I decide to be treated with Suboxone, when will I start to feel better?  

Most patients feel a measurable improvement by thirty minutes, with  the  full  effects  clearly  noticeable after about one hour. 


2.  How long will Suboxone last?

After the first hour, many people say they feel pretty good for most of the next day.  Responses to Suboxone will vary based on factors such as tolerance and metabolism, so each patient's response is different.  Your doctor may increase or divide your dose of Suboxone during the first week to help keep you from feeling sick.  

3.  Can I go to work right after my first dose?

Suboxone can cause drowsiness and slow reaction time.  Your ability to drive, operate machinery, and play sports may be affected.  Some people go to work right after their first Suboxone dose; however, many people prefer to take the first and possibly the second day off until they feel better. Compared to other opiates, suboxone causes much less drowsiness and leaves you more alert and functional.

4.  Is it important to take my medication at the same time each day?

In order to make sure that you do not get sick, it is important to take your medication at the same time every day.  The most noticeable effects of the drug last about 24 hours. It is best to take your dose at one "sitting," but you do not necessarily need to fit all tablets or films under your tongue simultaneously.  The most important thing is to be sure to take the full daily dose you were prescribed.  This allows your body to maintain constant levels of buprenorphine.  This becomes even more important when it comes time to taper off the drug.

5.  Why does it sometimes only take 5 minutes for Suboxone to dissolve and other times it takes much longer? 

 Many factors (eg, the moisture of your mouth) can effect that time.  Proper technique is most important in receiving full benefit of the medication.  Drinking something before taking your medication is a good way to help the tablet or film dissolve more quickly.  Don’t drink anything for at least 10-30 minutes after each dose

6.  What happens if I take other pain meds or heroin and then take Suboxone?

You may feel very sick and experience what is called a "precipitated withdrawal." The naloxone component of Suboxone competes with other opioids and will displace those opioid molecules from the receptors. Because SUBOXONE has less opioid effects than full agonist opioids, you may go into withdrawal and feel sick.

7. Can a person currently being treated with methadone switch to Suboxone (buprenorphine) without suffering withdrawal symptoms?


Patients can switch from methadone to buprenorphine treatment. However, because the two drugs are very different a plan and treatment strategy are important.  A number of factors affect whether buprenorphine is a good choice for someone who is currently receiving methadone. It is very possible for patients receiving buprenorphine to be switched to methadone under proper medical supervision. Patients interested in finding out more about the possibility of switching treatment should discuss this with the doctor who is prescribing their medication.


WISE Medical Center is a private discreet place where we can help with your efforts to deal with the difficulties associated with heroin or pain meds.