Reality: While it depends on how you define “recovery,” the abstinence-based models that have dominated the past century of addiction care are generally giving way to a more modern conception of recovery that encompasses the use of medications such as Suboxone that regulate your brain chemistry. As addiction is increasingly viewed as a medical condition, Suboxone is viewed as a medication for a chronic condition, such as a person with diabetes needing to take insulin. To say that you aren’t really in recovery if you are on Suboxone is stigmatizing to people who take Suboxone, and it’s not the medical reality of effective addiction treatment.

Reality: Suboxone, like any opiate, can be abused. However, because it is only a “partial” agonist of the main opiate receptor (the “mu” receptor), it causes less euphoria than the other opiates such as heroin and oxycodone. In many cases, people may use Suboxone (or “abuse” it, if that is defined as using it illegally) to help themselves manage their withdrawal, or even to get themselves off of heroin.

Reality: It is extremely difficult to overdose on Suboxone alone. It is more difficult to overdose on Suboxone compared to other opiates, because Suboxone is only a partial opiate receptor agonist, so there is a built-in “ceiling” effect. This means there is a limit to how much the opioid receptors are able to be activated by Suboxone, so there isn’t as great a risk of slowed breathing compared with potent opiates such as heroin, oxycodone, or morphine. When people do overdose on Suboxone, it is almost always because they are mixing it with sedatives such as benzodiazepines, medicines that also slow breathing.

Reality: In a perfect world, addiction treatment would include MAT and therapy, support groups, housing assistance, and employment support. But that doesn’t mean that one component, in the absence of all of the others, doesn’t constitute valid treatment for addiction. About 10% of people with addiction are getting treatment, so while combination treatment is an admirable goal, it is unrealistic to expect that everyone with an addiction will receive all the aspects of treatment that they need, especially without access to regular healthcare, insurance, or both.

Reality: Expert practitioners have different theories on how long Suboxone treatment should last for, but there is no evidence to support the claim that Suboxone should be taken for a short period of time as opposed to being maintained on it for the long term, just as a person would manage their diabetes with insulin for the long term.