You may not realize this but before buprenorphine treatment with suboxone or subutex was available, it was extremely difficult to treat opiate addiction outside of a hospital based detox. This all changed in 2002 when buprenorphine became legally available as suboxone and subutex formulations. Keep in mind that buprenorphine is available as both forms - suboxone and subutex.

But opiate addiction treatment with buprenorphine does NOT always go smoothly. In fact I have identified keys to success - or failure - with suboxone - subutex treatment.

I'm often asked what the most common mistake is that people make when they enter buprenorphine suboxone treatment. (Unfortunately, their are plenty of common buprenorphine suboxone mistakes made by patients and treating physicians.

The most common one is related to the person's mindset about the suboxone treatment itself. People who are most successful with this process are those who realize that the medication is NOT the most important part of the treatment process. This statement may seem strange, so let me further explain.

Most people who come to me for treatment have been dependent on their opiate (hydrocodone, oxycontin, heroin, percocet, etc.) for an extended period. This could be many months or years. Most of them have never heard of buprenorphine. That means that they have been in an intense opiate addiction pattern of behaving for a long time. This pattern has literally taken over their life - they spend alot of their time thinking about getting the next dose so they don't go through withdrawal. Other life obligations - to varying extents - are placed secondary. They will let nothing get in their way of making sure they get their opiate.

Additionally, their is the learned, repetitive behavioral pattern of actually reaching out for the opiate addiction every few hours or so that has been ingrained into their minds.

Once on the buprenorphine (suboxone or subutex forms) their is no more need to reach out for something to feel better. Their is no more need to be psychologically "thought focused" on getting the next "hit". This is great ofcourse, and the goal of the medication. And the fact that the buprenorphine treatment is so easy when done right further lulls people into a false sense of the suboxone or subutex itself doing all the work.

However, this is also where their can be problems. Since you have been dealing with this addicted pattern for so long, your brain is not going to simply "forget" it once you are on a stable dose of buprenorphine.

You may still have stressors in your life that may trigger a craving - even a mild one - that can put you at risk for snapping back into the addiction even if you are on the medication.

This is the problem I see with many people who simplistically look at being on the medication as the sole way to recover from opiate addiction. But the medication does NOTHING to help your "unlearn" the addictive pattern and learn new, more empowering life patterns that help you avoid relapse and truly be in addiction recovery.

Simply put, those people who view opiate addiction recovery as simply taking buprenorphine and doing nothing else to enhance recovery are the most likely to fail and begin to use again once the intial detox with the medication is over.

The most successful in my practice are those people who realize that the buprenorphine medication (as suboxone or subutex) in combination with addiction oriented psychotherapy is the best way to go.

Keep this in mind before you enter treatment and make sure that whoever is prescibing the buprenorphine is a DEA certified suboxone-buprenorphine doctor and able to deliver high quality psychotherapy or at least puts a high degree of importance on it and gives you an appropriate referral.