This blog has a point of view. We’re not fans of maintenance. (Though we still think Suboxone can be a very useful detox tool.)
If you want to read defenses of Suboxone, you can find a couple here:
- The Media Needs to Stop Stigmatizing Our Best Weapon Against Heroin Addiction – “tainted, to bourgeois eyes”
- New York Times Panics Over Un-Risky Drug Buprenorphine “usual bits of [NYT] fearmongering “
The best critical response is from addictiondoctor.org, though he’s not making a recovery argument. He’s really making a harm reduction argument.
It’s key to remember that there is an epidemic of opioid overdose deaths in this country largely fueled by the unrestricted access to long active high potency full opioid agonists in “pain clinics” around the country. It’s strikingly ironic that in the midst of this, there is controversy about a long acting partial agonist that is much safer and has been used in hundreds of thousands of people to stop the compulsive use. What is even more ironic is that the use of Suboxone is limited while any physician can prescribe nearly limitless quantities of the more deadly full opioid agonists.
The NY Times published a few reactions to its Suboxone series.
There were a couple of letters from physicians writing in support of Suboxone.
There was also a letter from a recovering person.
Thank you for exposing the dark side of the recovery and pharmaceutical industries’ approach to addiction. I’m dropping my own anonymity today.
It took me 14 years of fits and starts to finally earn a decade of continuous sobriety. To stay sober I need four meetings a week.
I see buprenorphine sweeping through the recovery population. It’s obvious that newbies and kids are suffering from it the most.
And, a physician who used to be a fan, but is no longer.
As one of the earliest of the Pennsylvania physicians approved to prescribe buprenorphine, I was part of a wave of optimism. After decades of helping addiction patients struggle to save their lives, I was initially quite heartened with the results of buprenorphine. Now, the “bloom is off the rose” as I, too, see the patterns of abuse and diversion.
There were lots of reader comments that were positive and negative about Suboxone. Here’s one that captures what we hear from a lot of addicts and families seeking help getting off of Suboxone:
My son has been an opiate addict for years. Through countless detoxes and rehabilitations he found himself on suboxone. What isn’t discussed is that this is a controlled substance that is hardest of all to withdraw from. It is an opiate. My son on suboxone continued addict-type behavior. Sure, he was functioning a bit better but not good enough. He was listless, with no attention span and without any sense of urgency to taking care of himself. My wife and I realized this is a pervasive horrible substitute for sobriety and we told my son we would not support it any longer. He still struggles to find a lasting sobriety. Opiate addiction is all the evils everyone talks about and I don’t need to repeat them. But suboxone is not the answer to finding true sobriety. Doctors are too keen to provide this as a solution but it continues one’s addiction not only to the opiate but to the behaviour that si typical of addicts. We pray and continue to support ways to help my son find a true sobriety, but one opiate substitute for another is not the answer.
Here’s a comment from our facebook page:
Suboxone is perfect for keeping the addict trapped in the dark place of turmoil that so many of us are in when we are first clean. I’m not sick but I still need a steady supply of drugs just to sleep. I have no healthy ego because my life still sucks and no coping skills outside of self destructive survival behaviors that kept me alive on the street. The addict eventually has to choose between a life with little to no quality or one where they have the relief of temporary highs. You can’t get off drugs by staying on drugs. Suboxone is no different than when I got off heroin and methadone In 97 and then spent 17 yrs drinking myself to death culminating in a suicide before getting sober last year. I was off the “bad drugs”And on the one that’s acceptable.
Related articles
- Suboxone Abuse Worries Officials in Vermont (addictionts.com)
- Addiction Treatment With a Dark Side (addictionandrecoverynews.wordpress.com)
- The Media Needs to Stop Stigmatizing Our Best Weapon Against Heroin Addiction (newrepublic.com)
- A Lifesaving Treatment, and a Killer (nytimes.com)
- New York Times Panics Over Un-Risky Drug Buprenorphine (reason.com)
- At Clinics, Tumultuous Lives and Turbulent Care (nytimes.com)
- Bangor councilors to consider moratorium on suboxone treatment center expansions (bangordailynews.com)
- “The Situation” with PHARMA (addictionandrecoverynews.wordpress.com)
- Who’s guarding the hen house? (addictionandrecoverynews.wordpress.com)
Addiction & Recovery News 
I think Suboxone can be a effective part of the journey for opiate addicts although it is clearly only a tool. The problems arise when it is seen as ‘the treatment’. When used in a recovery-oriented setting, prescribed by practitioners who understand the key elements of recovery and where there is active connection to vibrant recovery communities, it can prove most useful.
Unfortunately the use of Suboxone over the years has gone the route of many other useful medications. Expanding (off label prescribing) use increases complications, may decrease effectiveness and often causes unforeseen problems. Using Suboxone for maintenance (“replacement”) therapy decreases motivation for doing the hard work of recovery and addressing the emotional, spiritual, and mental aspects of the disease of addiction. It is like giving a diabetic insulin (replacement therapy) without repeated instructions and reminders about, and continuous attention to diet, skin care, periodic eye exams, kidney function checks, exercise.