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Medications for opioid use disorder, including Suboxone, have fast become the standard of care in the U.S.

Suboxone’s physical and psychological side effects are often ignored in the understandable push to save lives.

Many people who survive opioid addiction with Suboxone could thrive with full abstinence.

I’m going to take some heat for this, but I'm convinced it needs to be said. Robert F. Kennedy Jr., U.S. Secretary of Health and Human Services (HHS), is right to encourage abstinence in treating opioid use disorder. Not as an only option, but as a preferable option for the many people struggling with opioid addiction who are well-suited for it.

A renewed debate over addiction treatment

Kennedy’s Safety Through Recovery, Engagement, and Evidence-based Treatment (STREETS) Initiative, launched in early February, emphasizes abstinence-based outpatient treatment, which many public health officials and addiction scientists object to in favor of harm reduction, particularly medications for opioid use disorder (MOUDs).

The term "harm reduction" refers to almost any strategy used to save lives by minimizing the negative consequences of addiction, especially homelessness and overdose deaths. Everyone can agree that saving lives is urgent, but quality of life matters, too. Suboxone treatment, a primary MOUD and the current standard of care according to public health officials and the American Society of Addiction Medicine, comes with high costs to quality of life, which its proponents often overlook.

The overlooked downsides of Suboxone

Suboxone contains both buprenorphine, itself a powerful opioid, and naloxone (Narcan), which, at the doses prescribed, partially blocks opioid receptors. Buprenorphine prevents withdrawal on the one hand, while naloxone reduces chances of........

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