The answer to this question depends on whom you ask.

There are those who define recovery as the complete abstinence from any mind-altering drugs. And Suboxone®, a medication that combines the opioid buprenorphine with the blocker naloxone, does activate opioid receptors but it produces a smaller response.

It relieves drug cravings without the high or dangerous side effects caused by other opioids. Regular use can lead to physical dependence. So, can it really be considered recovery if I'm taking it?

Perhaps this is not the right question to be breaching. The more relevant question may be: What beliefs and behaviors can best support your recovery, to live a life in the service of what you value According to Richard Rohr, founder of the Center for Action and Contemplation, "Bill Willson saw 'emotional sobriety" as the final culmination of the Twelve Steps.

Full sobriety is not just to stop drinking (drugging), but to become a spiritually awakened person who has found some degree of detachment from your own narcissistic emotional responses.

Suboxone vs. Naltrexone vs. Methadone Therapy

For years the Coleman Institute for Addiction Medicine has specialized in Accelerated Opioid Detoxes to help people get off and stay off opioids such as oxycodone, hydromorphone, hydrocodone, fentanyl, heroin, kratom, and methadone, as well as buprenorphine. After clearing opioids from the body, we use long-acting naltrexone in the form of an implant or injection. This treatment is an excellent choice for many people and continues to be an available option at all the Coleman Institute offices around the country.

Currently there are threeMedication-Assisted Treatments (MATs) for patients with an Opioid Use Disorder (OUD) - Methadone, Suboxone, and Naltrexone. While each one of these treatments can be commonly prescribed to treat opioid addiction, their overall effectiveness in treatment varies greatly. Take Methadone for example, like heroin or opiates, this medication is known as a "opioid agonist" and is typically used in parallel with other addiction treatment therapies. While safer than some opioid agonists, if not carefully managed, it is easy for patients to get intoxicated or overdose.

When we look at another treatment, like Suboxone - contrary to Methadone, this treatment works on its own and is considered to be a safer alternative for detox. However, the substance is highly controlled and different treatment programs differ in requirements for patients. For those using Suboxone, it binds more strongly to the brain receptors than the short-acting opioids, making the treatment block overall effects without fully activating them. For many patients they tend to lean towards Suboxone due to its monthly dosage instead of daily, yet, because this drug is an partial opioid it can cause severe withdrawal symptoms.

Despite the two pervious treatment options, Naltrexone is a treatment that when taken "binds to the opiate receptor" as if it were an opiate while acting as a pure blocking agent. Many times we describe the use of Naltrexone as a "tight bond to the receptor" preventing the possibility of a competing drug like heroin or oxycodone to interfere. For those patients using Naltrexone as a treatment, this option typically does not cause physical dependence and therefore eliminates withdrawal symptoms from occurring. Of all the treatments, given our thirty years of experience, we recommend Naltrexone.

The Path to Recovery Looks Different for Everyone

As awareness of the opioid crisis has exploded over the last decade, so has the opportunity to understand more about the disease of addiction, particularly Opioid Use Disorder (OUD). This growing body of knowledge reinforces over and over again to those in the medical addiction profession that treatment is not a "one-size-fits-all" phenomena. And while historically the Coleman Institute's focus has been on treating Opioid Use Disorder with long-acting naltrexone, there have always been a few patients on Buprenorphine (Suboxone, Zubsolv, or Bunavall). These patients have found that this treatment allows them to manage all the moving parts in their own lives, putting attention on the most important areas, and eliminating drug-seeking behavior.

The Substance Use Disorder Recovery Process

It's also helpful to recognize that different patients experience different recovery styles once their path towards treatment and a healthier lifestyle. What one individual chooses as a moderator during their treatment may differ completely from the other. For example, the way you deal with stress, who you allow as your support system, and what you do during your detox can all play a role during your recovery.

Take Steven, a recent patient who stated how important it was for him to find a treatment plan and team that made understanding his addiction open and honest. He states, "Had it not been for the case manager who showed thoughtfulness, patience and training; I would not have made as much progress in my recovery."

Like Steven, many patients have been first introduced to treatment programs where the main mission is to provide a "temporary fix" by implementing substances that can actually do more harm than good. At the Coleman Institute, our treatment plans focus solely on the patient's path to recovery in a professional, compassionate, and supportive environment. Offering honest and open communication, from the beginning of your detox journey to the final days towards your journey to an improved lifestyle.


We are pleased to share that our treatment options in the Richmond, Virginia office include buprenorphine treatments as we welcomed the expertise of Applegate, our affiliate who also is devoted to helping people achieve their life goals through recovery.

Their proficiency in treating patients with Suboxone dovetails beautifully with the philosophy of the Coleman Institute for Addiction Medicine to work with our patients where they are and to provide the best options for sustainable, long-term recovery.

Choosing any of the Medication-Assisted Treatment (MAT) options requires careful consideration of each patient's unique circumstances.

We welcome your call at 804-294-2212 as you navigate through these complexities.

Joan R. Shepherd, FNP

We also offer a medically-assisted alcohol detoxfor people who's drinking is at such a level that it is dangerous to stop abruptly.