As Medication Assisted Treatment (MAT) has grown in popularity, more people in recovery are prescribed Suboxone (buprenorphine) and other MAT medicines than ever before. Step-down protocols and harm reduction measures like MAT have always stirred up a little bit of controversy in certain recovery circles. 

So are you sober if you’re on Suboxone or not? This North Jersey Recovery Center article answers that burning question and several other popular queries about MAT. 

What Is Recovery Really About?

Let’s start with the fundamental questions. What is recovery really about? Recovery is the act of halting the progression of a disease of the mind, body, and soul, called addiction. Not only halting addiction in its tracks but repairing the damage it has done. Recovery is a journey of self-discovery and personal growth. 

It’s also a lifestyle. That means we don’t just “recover” and then we’re fixed. We continue in recovery for the rest of our lives. Any tool that can help someone in their recovery without harming them or someone else should be on the table and that includes MAT. 

Recovery is really about:

• Stopping the progression of the disease of addiction.
• Repairing the damage done by addiction.
• Learning to better understand and love yourself.
• Growing as a person, especially spiritually and morally.
• Committing to the sober life and to helping others. 

Where Does MAT and Suboxone Fit Into Recovery Though?

For millions of people,  Medication Assisted Treatment (MAT) is a part of the recovery process. Make no mistake, MAT is not recovery by itself, nor is it a substitute for doing the work of recovery. It is simply a tool to help people in early recovery maintain their sobriety. It’s not necessary for everyone. Many, many patients do very well without MAT.

Many people who do participate in MAT find they reach a point where they no longer need Suboxone or other medicines. With medical guidance, they lower their dose over time and stop. Others find it to be a necessary harm reduction measure that they continue to use indefinitely. That’s a personal choice that each individual needs to make with qualified medical advice. 

What Is Suboxone Exactly? How Does It Help?

Suboxone is a prescription medication that combines buprenorphine and naloxone. It’s used to treat opioid addiction, including addiction to heroin and narcotic painkillers. The primary active ingredient, buprenorphine belongs to a class of drugs called mixed opioid agonist-antagonists.

Suboxone works by binding to the same receptors in the brain as other opioids, but it doesn’t produce the euphoric high or peaks and valleys. The main purpose of using Suboxone in MAT is to mitigate withdrawal symptoms and cravings associated with opioid dependency.

The buprenorphine molecule is especially “sticky”, meaning that it tends to occupy the opioid receptors for a while and it’s not easily dislodged. This has two benefits. One, it has a long-lasting duration of effect that staves off cravings. Two, opioid receptors already occupied by buprenorphine, a partial mixed opioid agonist (and an antagonist at the κ-receptor) cannot be activated by another drug. 

OK, But How Can Suboxone Help Prevent Relapse?

In simple language, this means that even if someone on Suboxone slips up and tries to abuse an opioid like heroin or oxycodone, the euphoric effects will be largely blunted by the Suboxone already in their system. Simply knowing this can help dissuade people in early recovery from picking up. That’s not the main purpose of Suboxone in MAT, but it is a useful fringe benefit for sure. 

Suboxone also contains an opioid antagonist called naloxone. That’s the same stuff in the overdose-reversing medicine NARCAN. The naloxone helps prevent someone from using their Suboxone in a manner other than how it’s meant to be taken (under the tongue). So, Suboxone can help prevent relapse by sharply reducing cravings, making ‘picking up’ less attractive and preventing misuse. 

Suboxone helps prevent relapse by: 

• Sharply reducing cravings for opioids.
• Making ‘picking up’ less attractive because the euphoric effects are blocked.
• Preventing misuse of the buprenorphine (because of naloxone)
• Establishing a pattern of sobriety — allowing the person to accumulate time. 

MAT is More Than Just Suboxone

This is a very important point to drive home. First of all, Medication Assisted Treatment doesn’t always use Suboxone. A raft of other medicines may be part of MAT, including antidepressants and non-narcotic anti-anxiety medications. But MAT isn’t just medication. It includes treatment planning, therapy, and counseling. 

Medication is only part of the process. Simply giving people Suboxone without a plan, goal setting or therapy wouldn’t be nearly as helpful. This is part of the reason why MAT programs are structured the way they are and why states in fact mandate that they must offer counseling, therapy, and life skills with the medicine. 

Is Someone On Suboxone Sober?

We say, YES. Someone in an MAT program who is taking Suboxone as prescribed and not using any drugs or alcohol is sober.  At the end of the day, this is really about intent, isn’t it? If someone mistakenly ate part of a THC edible at a party or unknowingly took a sip of a drink containing alcohol, would you accuse them of relapse? Shame them into picking up a white chip or key tag? No, of course not. Why though? 

Because there was no shift in their behavior or intent. They didn’t waver in their recovery and try to get high. They simply made a mistake. Now consider MAT and Suboxone. No, we’re not saying people take Suboxone accidentally or that MAT is a mistake. What we’re saying is that the intent of people who take Suboxone or any other MAT medicine as prescribed is not to get high. In fact, it’s very much the opposite. People participate in MAT programs and take Suboxone because they don’t want to get high. 

Shame Kills People

That’s a bold statement, we know. But we can back it up: MAT and Subooxone are clinically proven to help people get into recovery and stay sober longer. Those are just the facts. Regardless of how you, or a well-intentioned, book-thumping friend may feel about Suboxone or MAT, it SAVES LIVES. Period. 

So why are we saying shame kills people? Because some people in some 12-step meetings have been known to frown upon MAT and Suboxone. They may even shame people for taking Suboxone as prescribed or tell them they “aren’t really sober”. While outreach and awareness is growing and this problem isn’t common — it’s still out there. 

MAT is A-OK

You never know how close someone else may be to a relapse. If they are an opioid user especially, their next use could end in a fatal overdose. Do you want to be the person who shamed them out of participating in a Suboxone program? MAT isn’t for everyone, but it is up to the individual and their doctor to decide. No one should EVER be shamed for using Suboxone or any other MAT med as prescribed. 

Medication Assisted Treatment in New Jersey

If you or someone you love is not sober but would like to be — North Jersey Recovery Center is ready to help. Our world-class, dual-diagnosis addiction treatment program in New Jersey includes a comprehensive MAT program. 

Our MAT programs are designed to fit into a busy schedule, where necessary with day and evening IOP therapy available. Everything you or the person you love needs to overcome addiction is right here. But it’s up to you to make the first move. 

Pick up the phone and let’s give you a reason for hope today. Reach us at (877) 790-5873