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Addiction (Expert Forum)
Physical side effects of long term Sub use
Answered by
Jeffrey T Junig, MD PhD - Psychiatry, Addictions, Chronic Pain Treatment, Anesthesiology, Buprenorphine
Fond du Lac Psychiatry
Fond du Lac - WI
Questions in the Addiction forum are answered by a medical expert.
Physical side effects of long term Sub use
by flmagi, Jul 26, 2009 01:04PM
Dear Dr. J,
A lot of longer term Sub users have reported (to each other here on the forum) some side effects like numbness in the arms, pain in elbows and hands falling asleep. Have you heard of these side effects and are there others that we don't here about often but are definitely related to long term Sub use? My 2 sisters and myself are all on Sub and have been for over a year. We have all developed this problem as have others I've talked with. Any idea what causes this?
A lot of longer term Sub users have reported (to each other here on the forum) some side effects like numbness in the arms, pain in elbows and hands falling asleep. Have you heard of these side effects and are there others that we don't here about often but are definitely related to long term Sub use? My 2 sisters and myself are all on Sub and have been for over a year. We have all developed this problem as have others I've talked with. Any idea what causes this?
Doctor's Answer
by Jeffrey T Junig, MD PhD, Jul 30, 2009 10:38PM
, Jul 30, 2009 10:38PM
The active ingredient in Suboxone, buprenorphine, has been used clinically for over 30 years. There are IV formulations in use in hospitals, and there is a skin patch called 'butrans' in the UK that is used for chronic pain from osteoarthritis. So understand that this is not a 'new substance'. It IS a bit new, though, to take it in such high concentrations as are found in Suboxone.
For any substance, I follow the science-- anecdotes can cause a great deal of confusion. Do people here all know the story of silicone breast implants and autoimmune diseases? For years, everyone talked about getting fibromyagia or other conditions because of their silicone breast implants. Dow Corning paid a couple BILLION dollars in settlements. Then a huge study put the issue to rest-- there is NO relationship between silicone breast implants and autoimmune diseases. For awhile there, everyone was certain that they were connected! They were taken off the market by the FDA, and the lawyers were running ads, and winning.
Now, silicone breast implants are back on the market after the FDA quietly reversed itself. There were no headlines about the 'lack of a connection'. This type of thing happens quite often, and the press usually gets it wrong. And when the truth comes out there is no fanfare.
My point is that you have to be careful with anecdotal reports. I don't know if there is some true connection between Suboxone and hand numbness, but many people on or off Suboxone get hand numbness; once a person is on Suboxone, he tends to blame every new symptom on it. Every person who gets hand numbness who takes Suboxone sees this as 'another case': everyone who gets hand numbness NOT on Suboxone is not discussed.
To give another example, whether or not global warming is 'real', you will see how the expectations change perception: when it is hot, people say 'wow, that global warming is horrible', but when it is cold nobody says the reverse.
At this point we do not know of long-term harmful effects from taking Suboxone. One last comment though: it is known that treating childhood cancers with radiation increases the risk of cancer later. Does that mean we don't treat childhood cancers? Of course not! Opiate dependence is often fatal, and almost always very destructive; the success rates for 'will power' and even for residential treatment are low, below 50% by a longshot in most studies. So I would be willing to accept some risk of side effects with Suboxone, given the risk of NOT treating the disease of addiction. Eventually something better will come along, but for now, outside of constipation, buprenorphine is a pretty good maintenance agent for some people.
For any substance, I follow the science-- anecdotes can cause a great deal of confusion. Do people here all know the story of silicone breast implants and autoimmune diseases? For years, everyone talked about getting fibromyagia or other conditions because of their silicone breast implants. Dow Corning paid a couple BILLION dollars in settlements. Then a huge study put the issue to rest-- there is NO relationship between silicone breast implants and autoimmune diseases. For awhile there, everyone was certain that they were connected! They were taken off the market by the FDA, and the lawyers were running ads, and winning.
Now, silicone breast implants are back on the market after the FDA quietly reversed itself. There were no headlines about the 'lack of a connection'. This type of thing happens quite often, and the press usually gets it wrong. And when the truth comes out there is no fanfare.
My point is that you have to be careful with anecdotal reports. I don't know if there is some true connection between Suboxone and hand numbness, but many people on or off Suboxone get hand numbness; once a person is on Suboxone, he tends to blame every new symptom on it. Every person who gets hand numbness who takes Suboxone sees this as 'another case': everyone who gets hand numbness NOT on Suboxone is not discussed.
To give another example, whether or not global warming is 'real', you will see how the expectations change perception: when it is hot, people say 'wow, that global warming is horrible', but when it is cold nobody says the reverse.
At this point we do not know of long-term harmful effects from taking Suboxone. One last comment though: it is known that treating childhood cancers with radiation increases the risk of cancer later. Does that mean we don't treat childhood cancers? Of course not! Opiate dependence is often fatal, and almost always very destructive; the success rates for 'will power' and even for residential treatment are low, below 50% by a longshot in most studies. So I would be willing to accept some risk of side effects with Suboxone, given the risk of NOT treating the disease of addiction. Eventually something better will come along, but for now, outside of constipation, buprenorphine is a pretty good maintenance agent for some people.
i wanted to add that yes, i exp the numbness in the hands and pinching in arms every once in a while, i have a friend thats been on it as long as i have and she had a stroke at age 30 (with no prior related issues with the heart), i myself have been exp palpitations, rapid heart beats and bouts of elevated blood pressure. I was wondering if use of suboxone by women for more than 3 years has produced similar incidents in other users. I absolutly love suboxone and believe it to be the only treatment that actually works for Opiot addiction yet i am starting to worry about long term side effects.