Is it possible to take Lucemyra to get off Suboxone after taking it for years?

Suboxone is a life-saving medication. Many heroin addicts owe their lives to medication-assist treatment with Suboxone.

When I say Suboxone, I use it as a generic term to refer to all opioid addiction meds that contain buprenorphine. This includes similar sublingual and buccal drugs, such as ZubSolv, Subutex, and Bunavail.

Patients who take buprenorphine treatment to treat opioid dependence do well, avoiding prolonged opioid withdrawal symptoms and opioid cravings. Suboxone is an important part of addiction medicine, helping patients to overcome drug addiction involving opioids, such as heroin, fentanyl, oxycodone, and others.

After a year or more of Suboxone treatment, the patient may decide to taper off the medication with a goal of stopping buprenorphine treatment. At least a year of this opioid detoxification process is required for the best long-term results.

Stopping Suboxone after long-term use can be difficult. Lowering the dose, or quitting the medication, can lead to acute withdrawal symptoms.

Lucemyra, or lofexidine hydrochloride, is a drug approved by the FDA to treat opioid withdrawal symptoms. Can Lucemyra help patients to taper off and quit Suboxone?

Is it true that Lucemyra is just an expensive version of clonidine?

For decades, doctors have prescribed clonidine, an older blood pressure drug, to ease opioid withdrawal symptoms during medically supervised withdrawal from opioids. Clonidine is an alpha-agonist and, besides lowering blood pressure, it also reduces the intensity of opiate withdrawal and opioid withdrawal.

A major drawback of using clonidine to treat acute opioid withdrawal is the danger of dropping the patient’s blood pressure too far. Low blood pressure, or hypotension, can cause serious adverse effects.

To avoid low blood pressure events, doctors instruct their substance abuse treatment patients to limit use of clonidine. They may insist on no more than two or three uses per day.

While clonidine does help to reduce withdrawal severity, its usefulness is limited. Patients often complain that it seems as if it would have helped more if they were allowed to take it more often.

Lucemyra is similar to clonidine. It is also an alpha agonist drug, with similar effects. One thing that Lucemyra does not do as well as clonidine is to lower blood pressure.

So, while Lucemyra is, in a sense, an expensive version of clonidine, it does have a significant unique advantage. Lucemyra can be taken more often than clonidine, because the risk of low blood pressure is greatly reduced. When it comes to Lucemyra versus clonidine, each has its advantages, but Lucemyra may ultimately be the best option.

Why do Suboxone patients get stuck on Suboxone for so long?

It is clear that the manufacturers of Suboxone and similar drugs do not intend for patients to ever stop taking their medication. The lowest dosage of Suboxone is 2 mg, which is too high a dose for a patient to stop taking without tapering further.

In order for patients to quit Suboxone, they often cut their Suboxone films into small pieces to taper to the smallest dosage possible. The manufacturers include in their instructions a statement that the medication should not be broken or cut, with little explanation.

Another issue that makes quitting Suboxone difficult is that with each dose reduction, the patient experiences an exacerbation of opioid withdrawal symptoms. This effect becomes more pronounced as the patient tapers towards lower dosages.

For example, tapering below 4 mg is more difficult than tapering below 8 mg. Tapering below 2 mg is far more difficult than tapering below 4 mg.

Many patients choose to plateau indefinitely at a particular dosage. They decide they are comfortable with 2 mg, 1 mg, or even with just a Suboxone crumb.

Is Suboxone tapering difficulty all in my head?

Quitting Suboxone is hard. Many people have described it as being more difficult than quitting heroin.

There are Suboxone patients who get angry, saying that if they knew how difficult quitting Suboxone would be, they would have never started. They say they would have preferred to just suffer through heroin withdrawal instead.

What they often forget is how hard opioid discontinuation can be during active addiction. When a person quits heroin, they develop severe opioid cravings, which put them at risk for relapse and overdose death.

While Suboxone treatment is life-saving, patients do get frustrated after long-term treatment, because they want to finally be done with it. They want to move on with their lives, free from all drug dependencies.

When an addiction treatment doctor tells their patient that the difficulty in quitting Suboxone is psychological, they are gaslighting their patient. Buprenorphine dependence is a real physical dependence, and it is not easy to quit, even at the lowest possible dosage.

Is Lucemyra the key to completing Suboxone therapy?

The missing element of medication-assisted treatment with Suboxone is an end game strategy. What is the exit plan for completing treatment after one year, two years, or three years of therapy?

Is it possible that Lucemyra can ease the tapering process, making it more tolerable? Will more people find it possible to finally complete their Suboxone therapy with the help of Lucemyra?

One major hurdle is the cost of Lucemyra. Yet, health insurance drug plans will cover it with a properly done prior authorization.

While Lucemyra will not make the process trivially easy, it will help many patients to get through the tapering and drop off process more easily. Lucemyra reduces Suboxone withdrawal symptoms, and it may also help with opioid cravings.

It may be worth it for more Suboxone doctors to consider prescribing Lucemyra to their patients. When a patient is confronted with tapering difficulty, Lucemyra may be helpful in getting past the difficult stages of tapering, and the final drop-off, when the patient takes their last dose of Suboxone.

Why not just take Suboxone forever?

There are patients who consider themselves to be lifers. They have no intention of ever discontinuing Suboxone treatment.

Many patients find that the medication does not interfere with their lifestyle. They appreciate the security of knowing that they are safer from the risk of opioid relapse.

Yet, there are reasons to consider stopping Suboxone after taking it for many years. One consideration is that we do not fully understand the long-term consequences of taking Suboxone for many decades.

While it does appear to be a safe drug for long-term use, and even indefinite use, it is always possible that experts will discover in the future that Suboxone treatment should have been limited to a shorter usage period. Benzodiazepines are an example of a class of drugs that doctors believed were safe for long-term use, and now we are finding that long-term use is not safe for many people.

Additionally, Suboxone can have adverse effects that are unpleasant. For example, Suboxone can cause dry mouth, like other opioids.

Dry mouth, or xerostomia, can lead to dental problems, including cavities, root canals, and tooth extractions. Many patients have blamed their dental problems on long-term buprenorphine use.

What if the government takes our Suboxone away someday?

It seems like an unfounded fear. Why would they outlaw Suboxone, or other buprenorphine drugs?

While there is the risk for stricter regulation of Suboxone prescribing and dispensing, it is unlikely that the medication will be taken off the market. Still, anything is possible. There are states that fear a new wave of pill mills, fueled by Suboxone prescribing rogue doctors.

A more serious threat may be the risk of losing access to medications in a natural disaster. In Florida, we are at high risk each year for hurricane strikes.

A hurricane can isolate and strand people for days, and even weeks. Businesses are shut down, and people rely on stored supplies, such as bottled water.

It is not easy to have an emergency supply of Suboxone. Pharmacies are strict about not filling prescriptions early.

Another issue is the lack of access to care. Doctors sometimes go out of business or stop prescribing buprenorphine unexpectedly, and some regions do not have many Suboxone doctors.

Will they give me Suboxone in jail or in the psych ward?

Suboxone patients who are successfully staying in recovery have far less risk of ending up in jail or the psych ward. Still, people can go to these institutions due to old, unresolved issues.

Incredibly, psych wards, rehabs, and jails have been known to cut off residents, cold turkey, from their Suboxone prescription. The authorities induce withdrawal symptoms and then believe that they have done the person a favor, detoxing them from buprenorphine.

Suboxone deprivation in an institution can be life-threatening to a patient who has had a successful course of therapy. The pain of withdrawal can push a person to suicide or relapse and overdose.

For this reason, someone who is doing well on Suboxone for many years might want to consider a gradual taper plan with a goal of completing therapy. There is no rush to stop Suboxone, but a long-term plan to be finished with therapy provides some additional life freedom.

When the patient is off Suboxone, after successful long-term treatment, they are no longer at risk for losing access to their medication. And, they no longer have to depend on a doctor’s prescription.

What kind of doctor can prescribe Lucemyra?

Lucemyra is a non-controlled medication without any special restrictions. Any doctor, or healthcare professional who can prescribe medications is allowed to prescribe Lucemyra.

Ideally, Lucemyra should be prescribed by the patient’s Suboxone doctor or addiction treatment doctor. Still, there is nothing wrong with getting the prescription from the patient’s family doctor or nurse practitioner.

One obstacle that will arise is the need for a prior authorization to get Lucemyra covered by insurance. While any doctor can do a prior authorization, not all doctors are willing to go through this sometimes difficult process.

If you are a Suboxone patient, you may want to ask your prescriber about Lucemyra. It is currently the only medication that is FDA approved to treat opioid withdrawal symptoms.

Since opioid withdrawal is an obstacle that makes Suboxone tapering and Suboxone quitting more difficult, Lucemyra may help ease the process. Your doctor can research Lucemyra and decide if it will be a helpful part of your treatment plan.