Suboxone is a synthetic opiate used to treat moderate pain and to treat opiate addiction. Suboxone was first approved to treat opiate addiction by the Food and Drug Administration in 2002. It is composed of buprenorphine, an opiate pain killer, and naloxone, a medication used to prevent opiate abuse and misuse. The side effects of Suboxone are similar to other long-acting opiates, but with the added benefit of a decreased potential for overdose due to having a maximum effective dose. The most common side effects of taking Suboxone include headache, withdrawal and pain, insomnia, constipation and nausea and vomiting.
Headache
In a study of over 3,000 opioid-dependent subjects, the Food and Drug Administration reported that 36 percent of Suboxone users experienced headaches. Regular opiates cause headaches because of a histamine release, but Suboxone does not trigger a release of histamine. DoublecheckMD reports that buprenorphine increases cerebrospinal fluid, which can impact intracranial pressure. As the body adjusts to the medication over time, the headache may subside.
Withdrawal and Pain
The official website for Suboxone reports that 25 percent of users experience withdrawal symptoms and another 22 percent report physical pain in general. The withdrawal may be caused by the ceiling effect of buprenorphine, compared to a previous unrestricted higher dose of another opiate. According the Food and Drug Administration, Suboxone has a maximum effective dose of 16mg, making overdose nearly impossible. In addition, naloxone precipitates withdrawal of other opiates. Buprenorphine itself blocks and reverses other opiates present in the system due to its dominant strength in binding to the opioid receptor.
Insomnia
Insomnia is another commonly reported side effect of Suboxone. Suboxone-induced insomnia may be caused by decreases in adenosine, a neurotransmitter that plays a crucial role in initiating the sleep cycle. In the December 2009 issue of Anesthesiology, Dr. Max Kelz stated that because opiates offset the adenosine balance, patients are often in a state of limbo caught between the sleep and wake state. Opiates also act as a central nervous system depressant, which can contribute to daytime sedation.
Nausea, Vomiting and Constipation
Digestive problems are also common side effects that Suboxone users may experience. These effects are usually more acute as long-term users generally become acclimated to its effects on the digestive system. The Palliative Medicine Handbook explains that Suboxone induced nausea and vomiting through a number of possible mechanisms: increased vestibular sensitivity, gastric stasis or impaired intestinal motility and constipation. The website Medical News Today states that opioids slow the movement of food down the digestive tract, paralyze the stomach and reduce digestive secretions, and inhibit the body's ability to initiate defecation.
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