Medication-assisted treatment with products containing buprenorphine seems to be the primary solution encouraged by official sources. But, determining the value of medication-assisted treatment requires considering both peer-reviewed studies and real-life experience in the calculation of risks and rewards.

Important aspects of buprenorphine use are its ongoing effects on quality of life and the difficulties people encounter when withdrawing from it.

To all appearances, medication-assisted treatment with products containing buprenorphine seems to be the big solution that many people are counting on to resolve our opioid epidemic. Use of Suboxone (buprenorphine + naloxone) is described as an “evidence-based” solution to addiction to opioids and the “gold standard” of treatment. 

What does evidence-based mean? The website www.nurse.com says that evidence-based care “incorporates the best evidence from well-designed studies, patient values and preferences, and a clinician’s expertise in making decisions about a patient’s care.”

You can search any medically-oriented website for their views on Suboxone and you’ll see praise like this from Harvard Medical School:

The vast majority of physicians, addiction experts, and advocates agree: Suboxone saves lives. The U.S. Government has recently been lightening up on the requirements needed for doctors and nurses to “get waivered” in an urgent attempt to increase the availability of Suboxone prescribers, as the number of opioid deaths keeps rising.

Here is the claim of one doctor who wants to attract Suboxone patients to his clinic: “the combination of Suboxone, counseling and behavior modification therapy allows an opioid addict to get clean and sober fast.”

If the experiences of real people using Suboxone to recover from opioid addiction match this praise, then we may have an excellent solution indeed. 

Real Comments from Real Users

We can collect the observations of real people using buprenorphine in real-life situations from forums and other online locations where they share their experiences. One such location is an informative blog found at https://mentalhealthdaily.com. In an undated post titled “Suboxone (Buprenorphine) Withdrawal Symptoms + How Long Do They Last?,” more than three hundred comments provide insight into the life of a person trying to end their dependence on opioids by using Suboxone. 

Here are some excerpts from their unvarnished reports. (Minimally edited for clarity and length.)

Day 4 without Suboxone. I’d been on it for approx one year & had tapered off during last 10 weeks. But I wasn’t prepared for the anxiety, runny nose, headache, stomach upset of past 3 days. Today the headache is gone but the restless legs even my arms kept me awake last night. And today I feel hot/cold, and have like an electric current running through my limbs.

Honestly the Suboxone withdrawal was so bad I started using heroin to help for a month then just WD’d off the heroin for 3 days. Easy peasy. I’m not even kidding. If I knew Subs were so much harder to get off I would have never started. They saved my life, but after 5 years I needed to get back to normal. It’s risky to start using again but it’s all I could do to get off the subs.

I’m on day 14 AS (after Suboxone). I was taking far more than most here, had I know then, I would have suffered the 3 day narcotic withdrawal and been done with it. So I’ve been on high doses of subs for 8 years. I went in on Feb 4 and did a FAST taper over 5 days. I was doing fairly well until they made me take naltrexone. OMG, talk about precipitated withdrawal HELL, I was puking or crapping from every orifice. I had to wear adult diapers for 3 days. When they released me, I had no business driving home, but I was NOT suffering like that on a hard, twin bed! I wanted to die at home. (LOL, I still have a faint sense of humor left)… I still feel very weak and still have the occasional crawling skin, diarrhea, stomach cramps, restless leg syndrome, and on and on and on. It is an EVIL, EVIL drug and people just need to jump from narcotics, suffer the 3 days and go on with their lives. This is a living hell. Honestly, the ONLY thing that keeps me going is the thought I can’t ever, ever, ever go through this again. As shaky as I feel now, it’s a tiny fraction better than 10 days ago. If I got my hands on Suboxone today, it would just drag this out. I want it OVER.

After 5 years on Suboxone I decided to quit cold turkey. I’m currently on day 16. Most of my physical WD’s are gone. Day 12 is when the mental part kicked in and I felt like I was going crazy. I felt like I was plugged into a light socket. I had no appetite which I can’t afford because I’m 5’6″ and weigh 110. I lost 7 pounds in 2 weeks.

Day 30 update. Max sleep is 6 hours. Still get chills and goosebumps also slight temp changes. Nightmares. Still wake up with a pounding heart and anxiety. Still sneezing (literally just did again). Just started to get dizzy last night and woke up feeling dizzy as well. The diarrhea let up two days ago finally. Bad taste in mouth and sense of smell is very heightened… I will continue to put up with this BS until it’s gone never looking back. That drug sucks and should only be used in EXTREME circumstances. Looking back at 10-20 a day Lortabs, Percocets, Norcos etc… I should’ve dealt with that withdrawal and never got on this drug. It almost ruined my life. At first I thought it was a savior of a drug but looking back if only I knew then what I know now about it I would not have got on it.

While taking Suboxone for 10 years I used to sleep all day and go to bed real late. Now I go to bed early and wake up early because if I don’t get out of bed the anxiety starts. Being on Suboxone it’s like my brain was numb to everything and I didn’t feel emotion. Now that it’s been three weeks off I still feel numb which I know is normal, but I get glimpses of the old me coming back.

The Value of Anecdotal Reports 

There’s value in peer-reviewed studies of medication trials. And that’s what is being relied on when the use of medication-assisted treatment is promoted as the “gold standard” of treatment for addiction. But the reports of people using medication-assisted treatment also have value. If we only rely on peer-reviewed studies, we only get a sanitized, scientific viewpoint on results. 

If we overlook the human side of the equation, we may well miss the true impact of a treatment we are trusting to help. Determining the value of medication-assisted treatment requires including both peer-reviewed studies and real-life experience in our calculations.