Addiction treatment has come a long way in the last two decades. Prescription drugs can now help keep drug and alcohol addicts away from their drug of choice. A few of the more popular brands are the sublingual opioid blockers Suboxone and Subutex, as well as naltrexone, Antabuse, and Campral for alcoholism. The approach, known generally as medication assisted treatment (also known as MAT), has gained widespread traction in conjunction with therapy and the lifestyle modifications offered by more traditional 12 Step programs. But not all MAT drugs are viewed equally by the fellowship. Suboxone in particular presents problems; although it blocks opioids, it is actually an opioid itself. This begs the question: Does Suboxone count as getting clean?
Understanding Buprenorphine & Naloxone
Suboxone is the brand name of a medication that combines buprenorphine with naloxone. But those two drugs are also available separately, and you need to understand all three to get a picture of how Suboxone fits into being clean.
There is no question that some addicts abuse the withdrawal treatment drug buprenorphine the same way they abused whatever their former opiate of choice was (heroin, oxycodone, etc). It does provide some of the same effects because it is, after all, an opiate itself. That’s why detox patients get tapered off pure buprenorphine (branded as Subutex) before going to residential treatment.
But some people in recovery choose to move on to long term maintenance (MAT) once detox is over. That’s when naloxone enters the picture. Naloxone, sold under the brand name Narcan, is an opiate blocker. It’s used by itself (typically as a nasal spray) to reverse opiate overdoses and save lives. By combining buprenorphine with naloxone, you get Suboxone, which provides a form of maintenance that ideally prevents abuse of buprenorphine via the presence of naloxone. So it’s not as simple as saying “Suboxone is an opiate”—because it’s also an opiate blocker.
The Big Book Bias
Absolute sobriety is a cornerstone of Alcoholics Anonymous. This non-negotiable approach helps to set clear boundaries that members of the fellowship can follow throughout their lives. It is understandable, then, that many AA members would answer the question, “Does suboxone count as getting clean?” with a resounding no. After all, you still have opiates in your system—and when it comes to a traditional reading of the 12 Steps, it’s all the same. Opiates are opiates. You’re not really clean and sober until you have completely given up.
The picture isn’t quite as cut and dry as the traditional AA fellowship may suggest. To their credit, the Big Book’s approach works very well for a significant amount of people. But every recovering addict is unique, and statistics show that MAT tends to have lower long-term relapse rates for opiate users. So
Does Suboxone Count as Getting Clean?
Before accepting criticism about Suboxone “not counting as getting clean,” consider your personal history with trying alternatives like total abstinence. Maintenance is a much better option than full blown relapse.
While MAT is not right for everyone, it can be a good option for some situations. Treatment counselors in detox can help you make this important decision. If you or a loved one is seeking help for a substance abuse problem, our addiction counselors are available 24/7 by phone: 855-737-7363