Suboxone And Constipation: A Serious Concern
Suboxone is a medication used to treat addiction to opiate and opioid drugs. For example, Suboxone can be used to effectively treat heroin addiction. Suboxone, along with drugs such as methadone and naltrexone, is prescribed by doctors as part of medication-assisted therapy for opioid addiction and dangerous opioid use.
Does Suboxone cause constipation?
Yes, and Suboxone constipation can be very unpleasant. While Suboxone is a unique medication, it is still an opioid and can cause constipation.
In fact, all opioids can cause chronic constipation. As described in this article, buprenorphine induced constipation, often referred to as Suboxone constipation, is a significant issue.
It is important to let your doctor know if you have this side effect or any other concerning Suboxone effects or Suboxone sickness. For example, if you have insomnia, headaches, ankle swelling, or excessive sweating, let your doctor know right away.
What is constipation? Why is my Suboxone making me sick in this way?
Constipation is simply a difficulty in emptying your bowels, often accompanied by significant stomach pain. Hence, if you find that you are straining to poop or it is painful to go, it may be due to Suboxone effects as a partial opioid agonist.
Does Suboxone constipate you as much as other opioids? For some people, Suboxone constipation can be a serious issue.
Why does Suboxone make you constipated?
In our intestines, we all have opioid receptors. When these receptors are stimulated by any opioid, they slow down the movements of the muscular intestinal walls that move food and waste material along.
Since Suboxone contains buprenorphine, a mild opioid, buprenorphine constipation is possible. In the large intestine or colon, this leads to more water absorption. The end result is difficulty in pooping. When you make an effort to push out the poop, you may experience constipation dizzy spells or constipation fainting.
Suboxone constipation is no laughing matter. While it does not affect everyone, if it happens to you, you are going to want some Suboxone constipation relief.
Drinking more water may help.
Because one of the issues involved in constipation is water absorption in the colon, drinking more water often helps to reduce constipation problems.
How much water should you drink in a day? While it is not a good idea to overdo water intake, you may find that you are not actually drinking as much water as you should be drinking throughout the day.
The ideal amount of water that a person should drink daily will vary based on gender, age, and weight. Typically, it is around three liters daily. Keep in mind that the typical bottled water that many people drink comes in a 1/2 liter bottle.
You would need to drink around six of those bottles throughout the day. Of course, you may want to carry a refillable water bottle to protect the environment.
People who have kidney problems may have to modify their fluid intake. If you have any kidney problems, ask your healthcare provider how much water you should drink. It may also help to track your water intake. Consider using a dietary tracker that includes water tracking.
Eat more fiber every day.
Generally, we are aware of the official recommendation to eat five servings of fruits and vegetables daily. Many of us do not even get this minimal amount of healthy natural foods.
When you are making plates of fruits or vegetables or when you are making a salad, look for the colors that you include. It is good to have a variety of natural, fiber-rich ingredients with various colors.
Bell peppers, tomatoes, cucumbers, lettuce, and much more can give you a healthy rainbow of delicious vegetables that make up a healthy salad. Fruits are also important. Be certain that you eat the fruit whole and not as a juice.
When fruits are juiced, the healthy and important fibers that can help improve constipation are removed from the fruit. A diet rich in fiber helps to increase the roughage passing through your intestines. This, combined with good fluid intake will help to overcome constipation difficulties.
Exercise makes a difference.
Are you often home, sitting on the couch or laying in bed? Do you avoid going out for a walk or jog? How about a swim? Exercise gets your body moving.
This is good for a variety of reasons. Exercise keeps your metabolism elevated and it helps to maintain your weight. Daily exercise in the form of walking can also protect your heart’s health.
In addition to these benefits, walking every day keeps your intestines moving and active. This, in turn, improves your general bowel health and helps to keep food and waste moving along through your system. Daily regular exercise can make a difference in improving problems with constipation.
Can Suboxone cause constipation bad enough to require medical treatment?
First, you can try the above described natural solutions. Try drinking more water during the day. When you do not have enough water passing through your intestines, you will be more likely to be constipated.
Also, walking, jogging and other forms of moderate exercise can help to get things moving. Another thing you can try is to increase the fiber in your diet. Fruits and vegetables are healthy and they contain fiber. Eating a salad every day is a good idea for everyone.
The exception is that if you have an intestinal condition that makes eating fiber-containing foods unsafe, you should take care and follow the specific dietary recommendations of your doctor. For example, diverticulosis is such a condition where eating too much fiber and seed-containing foods might be dangerous, putting you at risk for an acute case of diverticulitis.
Are there medications that can help? Is there a good Suboxone constipation remedy?
Many meds that help to resolve constipation are available over the counter in the pharmacy. There are products such as Colace, magnesium citrate or magnesium sulfate, Dulcolax (bisacodyl), milk of magnesia, mineral oil, castor oil, Mylanta, Miralax or ClearLax (polyethylene glycol), Gas-X (simethicone), Senokot, BeneFiber or Metamucil, acidophilus, and probiotics.
Docusate sodium is the ingredient in Colace and other brands. Docusate is a stool softener. It should not be taken if you already use mineral oil. In addition to oral forms of docusate, it is also available as an enema.
Senna is a laxative derived from an herb. Both leaves and fruit from the herbal plant are used to make senna-based medications. Senokot is an example of a medication based on senna. Senna can be used in combination with psyllium or docusate sodium.
Magnesium, in addition to helping with constipation, also helps with muscle cramps. Magnesium is a supplement that may also be helpful to reduce the severity of some symptoms of opioid withdrawal.
Even though you do not need a prescription for these meds, it is still important to discuss them with your doctor before taking them. Your pharmacist can also be helpful in making decisions about OTC meds.
Even though these medications do not require a prescription, you might still want to ask your doctor for a prescription if you have health insurance. It is possible that having a prescription will get your insurance company to cover the cost.
What about prescription medications for Suboxone constipation?
There is a relatively new medication for opioid-induced constipation, Movantik, also known by the generic name, naloxegol. Some patients who have Suboxone constipation find that this unique medication helps. Your doctor may even consider other prescription constipation meds.
For example, there is also methylnaltrexone, known by the brand name, Relistor. The names, naloxegol and methylnaltrexone may sound somewhat familiar. They are chemically related to the opioid blockers, naloxone and naltrexone, respectively.
These two drugs work by blocking opioid receptors in the gut. When an opioid drug, including the buprenorphine in Suboxone or ZubSolv, activates intestinal opioid receptors, the ongoing movement of the muscular intestinal walls is reduced.
Waste material, or feces, passing through the large intestine does not get pushed through as quickly. As a result, excess water is removed, causing the stool (the poop) to become dry and hard, making it even more difficult for it to pass through and leave the body.
The main job of the large intestine, or the colon, is to remove water. If too much water is removed, it can lead to painful constipation. On the other hand, if not enough water is removed, the result is diarrhea.
If you are wondering, how is it a good idea to take an opioid blocker such as Movantik or Relistor for opioid-induced constipation, you may be concerned about precipitated withdrawal. It is true, if you were to take one of the traditional opioid blockers, naloxone or naltrexone, you would experience precipitated withdrawal while on Suboxone.
The blocker would displace the buprenorphine molecules from the opioid receptors in the central nervous system. This blockade would lead to opioid withdrawal sickness.
The reason why these unique and newer opioid blockers do not cause precipitated withdrawal is that they are unable to cross the blood-brain barrier. They work in the body, including the intestines, but not in the brain or spinal cord.
Are there other prescription medications that can help with Suboxone constipation?
Amitiza, or lubiprostone, is a medication approved for treating chronic idiopathic constipation, irritable bowel syndrome with constipation, and opioid-induced constipation. Symproic, or naldemedine, is another prescription drug that is FDA-approved for treating opioid-induced constipation.
Linzess, or linaclotide, is a medication prescribed for chronic idiopathic constipation or irritable bowel syndrome with constipation. While it is not FDA-approved for opioid-induced constipation, some doctors do prescribe it off-label for this purpose.
Interestingly, patients have reported that Linzess has worked for them where other treatments, including other prescription medications failed. If nothing seems to be working to help with your Suboxone poop issue, you may want to ask your doctor about Linzess as a possible option.
Does Suboxone constipate you enough to cause you to stop taking it?
If Suboxone is causing constipation and nothing is working to resolve it, your doctor may consider reducing or stopping the Suboxone. In fact, often, the dosage can be reduced and still be just as effective.
Your doctor may want to try tapering down your dosage gradually to see if it helps. Another consideration is to try an alternative treatment for opioid addiction.
Bunavail is a similar medication to Suboxone. It also contains buprenorphine and naloxone. The difference is that it is a buccal film.
This means that instead of being placed under the tongue, Bunavail is pressed against the inside of the cheek. Some patients have found that they have less side effects from Bunavail compared to Suboxone.
What about naltrexone? Can that help with Suboxone constipation?
Naltrexone also has a high rate of success in treating opioid addiction. However, it can be difficult to make the switch from Suboxone to naltrexone. Fortunately, most people will find a solution with their doctor without having to stop taking Suboxone.
When naltrexone is prescribed instead of Suboxone to treat opioid addiction, it is either prescribed as a 50mg tablet or a monthly shot. There is another way to take naltrexone.
Low dose naltrexone, or LDN, means to take between 1mg and 6mg of naltrexone daily. To get such low dosages, you can ask your doctor to send a prescription to a compounding pharmacy.
LDN is used for a variety of conditions, from chronic pain to autoimmune diseases. The mechanism of action is different from the way that full strength naltrexone works.
There is also a product called ultra-low dose naltrexone, or ULDN. ULDN is measured in micrograms. At such low dosages, naltrexone may not interfere with Suboxone in the same way that full strength will. Some doctors have prescribed ultra-low dose naltrexone in the range of 50-60 micrograms to patients to help with side effects from Suboxone, such as constipation.
Is spitting out the Suboxone spit a good idea?
Interestingly, there is ongoing discussion and debate about the topic of swallowing vs spitting the Suboxone or ZubSolv saliva after the medication has fully dissolved. Patients are often motivated to swallow the saliva with the idea that it may contain medication which will provide an additional effect if swallowed.
The fact is that buprenorphine, the main medication in Suboxone, is not active when swallowed. It does not add to the beneficial effects when you swallow the saliva after your Suboxone is dissolved. However, it is possible that the swallowed buprenorphine will interact with opioid receptors in the gut.
Hence, spitting out the Suboxone saliva might help to reduce constipation. In addition to helping with constipation, some patients state that spitting out the saliva prevents headaches as well.
What about seeing a constipation specialist?
If nothing seems to be helping and you are in a situation where you do not want to make changes to your addiction medication treatment, consider seeing a specialist to further evaluate and treat your constipation. You can ask your family doctor for a referral to a gastroenterologist or. GI specialist.
This kind of doctor specializes in anything related to your digestive tract. This means that everything from where your food goes into where waste comes out is included in what they can handle.
In fact, if you are 50 years old, or if you are younger and have a family history of gastrointestinal problems, such as stomach or colon cancer, you should definitely see a GI doctor. Starting at 50 years old, it is recommended that all people get a colonoscopy.
A colonoscopy is a special test that uses a camera on a flexible tube to look through the entire large intestine. This means that the final stretch of the intestines is viewed thoroughly by the doctor. If there is an early precancerous growth, it can be removed during the colonoscopy.
Colonoscopies can prevent colon cancers and are highly recommended. Regarding constipation, the gastroenterologist is an expert in this area and can possibly put together a treatment plan beyond what your primary care doctor can provide.
What about alternative medicine?
There are areas of the medical field that are just outside the mainstream. These include things such as chiropractic, osteopathic manipulation, acupuncture, homeopathic remedies, yoga, massage, Reiki, meditation and more.
While some of these activities may have few benefits for treating constipation, others may be very helpful for certain individuals. In fact, osteopathic manipulation includes specific techniques for relieving constipation.
You may want to consider seeing an osteopathic physician who specializes in this form of treatment. Acupuncture may also be quite helpful. While you may not get dramatic results with these types of treatments, they are generally safe and worth trying in some cases.
Can the health food store help?
In addition to carrying lots of healthy fruits, vegetables, and legumes, your local health food store may also carry a variety of natural remedies in the form of supplements. Often, the supplement department will have a consultant who can direct you to a variety of safe alternative treatments for various symptoms and ailments.
Of course, you should always inform your doctor if you are taking a natural supplement. Some of these natural treatments can interfere with medical treatments.
In addition to looking at natural remedies, fruits and vegetables, don’t forget about other fiber-rich options, such as split-pea soup or lentil soup. There are many excellent foods that are full of healthy fiber and can help to improve your bowel movements.
What types of healthy snack foods can help with constipation?
First, there are some foods that you may want to avoid in order to improve the quality of your bowel movements. Patients have reported that reducing or eliminating soda (pop) and other foods rich in refined sugar helps to improve constipation.
Additionally, reducing or eliminating meats, especially red meats, and cheese can help you to have less constipation. Eating less of these foods will also positively impact your overall health.
Fruits, vegetables, and legumes (beans) are the foods that are most rich in fiber, which helps to sweep through and clean out your colon. Many people enjoy various dried fruits and find that they can help significantly in improving constipation.
Prunes are a big favorite. In addition to eating prunes, people have reported that prune juice is effective as well. Other dried fruits that have been touted as being helpful are dates, dried apricots, raisins, and dried cherries.
Fresh fruits may work well also. Some people have claimed that a combination of green apples and green tea have helped them with Suboxone constipation.
Another recommendation stated by some MAT patients is pumpkin bread or pumpkin rolls. Starbucks iced coffee, if you enjoy coffee already, may also help and could be a nice compliment to a piece of pumpkin bread or roll.
What are some supplements available in stores that might help?
The following supplements, which you can find in a health food store, grocery store, or at Amazon.com, may or may not be backed by scientific study. However, all have been reported by individuals to be helpful. As always, speak with your doctor before starting any supplement.
One product which has been recommended by various people is named “OLLY Keep It Movin’ Simply Fiber Gummy Supplements, Snappy Apple.” Unfortunately, it seems as if this product, which contains fiber from the chicory root, may no longer be available. Previously, it could be purchased at Amazon, Target, and Safeway. The description claims that it is a prebiotic, supporting and fueling healthy bacteria.
Another supplement product available on Amazon is Oxy-Powder, an oxygen-based natural colon cleanser. The product is poorly named, since people who have been addicted to opioids may not appreciate the similarity of the name to oxycodone or oxycontin. Yet, some Suboxone patients have reported success with this product.
One supplement I have heard of being used to help with constipation is Tegreen, which is a green tea-based capsule. It is promoted as a detox cleanse. There are other green tea supplements available that are likely similar.
Others have recommended coconut oil and even chia seeds. Regarding coconut oil, I personally have experience with a related supplement, MCT, or medium-chain triglycerides. MCT oil can be coconut oil-based and does seem to help prevent constipation. Again, check with your doctor to ensure that any of these supplements that you are considering are safe for you.
There are also super greens or green superfood, which are supplements with various greens to promote overall health, including spirulina, chlorella, digestive enzymes and probiotics. These greens products also contain various “healthy grasses” as well as vitamins and minerals.
Other supplements that might be helpful include some multivitamin preparations that are formulated for patients who take methadone for opioid addiction. Examples include Nutridone and Vitadone. Both of these products are available on Amazon.
How about hypnosis?
Another treatment that might be considered a part of alternative medicine techniques is hypnosis. Hypnosis provided by medical experts in the field has been demonstrated to be useful in helping people to quit smoking and to reduce food intake to help people lose weight.
As a behavior modification tool, it may be useful in helping you to change your lifestyle more consistently in such a way that your constipation will also improve. It is worth considering hypnosis if you are not yet getting the results you are looking for.
Could it all be in my head?
Constipation, especially when it is caused by taking a medication such as Suboxone, is a real problem. It is not at all just in your head. However, psychological issues, such as anxiety, may contribute to physical problems.
It is possible that learning to relax and deal with issues in your life more effectively may help you to improve your overall health and even to reduce issues with constipation. What is the best way to do this? You may want to see a doctor of psychology or a psychiatrist who specializes in psychotherapy.
Since psychotherapy is a cornerstone of medication-assisted treatment of opioid dependence, you should already be in therapy if you are taking Suboxone. Ask your psychologist or psychiatrist if anxiety or other psychological issues may be contributing to your constipation or other physical symptoms.
Can sound therapy help?
Again, this is in the area of alternative therapy. If anxiety is a contributing factor, there are specialized sound programs that can help you to enter a more relaxed, meditative state. For example, binaural beats programs are designed to play special tones that can help you to relax by entraining your brain waves and slowing down the overall activity in your brain.
These sound programs can also improve focus and mental performance. A binaural beat program is made up of tones that are slightly different in each of the two stereo channels.
When binaural beats tracks are played through headphones, your brain interprets a beat frequency and you hear a perceived pulsing in your mind that is not actually there, but it is created by the two differing sounds played in each ear.
For people who have hearing loss in one ear, there are also sound programs that are isochronic that can help as well. These programs use a similar hypnotic pulsing pattern but do not rely on the binaural effect.
Listening to the steady pulsing of binaural or isochronic sound programs is a form of meditation. Taking time throughout the day to have quiet time to yourself and relax and meditate can help to improve physical symptoms such as constipation.
What about biofeedback?
Biofeedback is a more advanced version of the sound programs described above. Rather than just listening to a pulsing sound program that will hopefully slow down and synchronize brain activity, biofeedback uses technology that actually measures brain activity and provides direct feedback to you, often via sounds played through headphones, to help you to make a difference in your own brain state.
While biofeedback equipment is more expensive and may require seeing a therapist that provides this service, it may be an effective way to train your brain to better enter states of relaxation and self-healing.
Healing our second brain.
The digestive tract in humans has been called by some scientists our second brain. In fact, some even call it our first brain, since it evolved before the central nervous system that includes our actual brains.
The intestines can function autonomously without the need for instructions from our nervous systems. Our intestines and stomachs appear to have a mind of their own! This is why we are often told that we should listen to our gut.
Our gut may be trying to tell us something when we have intestinal problems. Constipation is a simple problem that can be a result of complex issues. This is why we should think outside the box and consider many possibilities when it comes to making lifestyle changes to improve our bowel health and eliminate constipation.