Suboxone and Subutex are semi-synthetic medications that are most commonly used as a treatment for opiate addiction. In both their branded and generic forms, Suboxone and Subutex differ from other forms of opioid medications, like methadone, in that they have a lower potential for abuse.
Methadone is heavily controlled and can only be dispensed at authorized clinics by doctors who are registered under the Drug Enforcement Agency’s Narcotic Treatment Program. Suboxone and Subutex can be prescribed by any doctor who is certified by the Center for Substance Abuse Treatment. Both Suboxone and Subutex can be taken at home as a self-administered medication and both contain buprenorphine.
Suboxone and Subutex Contain Buprenorphine
Buprenorphine is the active ingredient of Subutex and Suboxone and in almost all other medicinal forms is used to manage chronic pain symptoms. Its chemicals work by linking with opioid receptors in the brain to reduce pain and create a feeling of well-being. Buprenorphine is a sublingual dissolving medication and belongs to a class of drugs called opiate agonists; buprenorphine is more specifically categorized as a partial opioid agonist. This means that although it can produce effects and side effects that are typical of other opioids, such as respiratory depression and euphoria, its maximal effects are less than those of full opioid agonists like heroin and methadone.
According to the National Alliance of Advocates for Buprenorphine Treatment,
At low doses Buprenorphine produces sufficient agonist effect to enable opioid-addicted individuals to discontinue the misuse of opioids without experiencing withdrawal symptoms. The agonist effects of Buprenorphine increase linearly with increasing doses of the drug until it reaches a plateau and no longer continues to increase with further increases in dosage. This is called the ‘ceiling effect.’
Thus, Buprenorphine carries a lower risk of abuse, addiction, and side effects compared to full opioid agonists. In fact, Buprenorphine can actually block the effects of full opioid agonists and can precipitate withdrawal symptoms if administered to an opioid-addicted individual while a full agonist is in the bloodstream.
Buprenorphine, Suboxone, and Subutex: Past and Present
Buprenorphine is a fairly new chemical and has only recently started to be approved for opiate addiction treatment within the last decade. In 2002, the FDA approved buprenorphine, in the form of Subutex and Suboxone tablets, for use in opioid addiction treatment. After the marketing protection on the branded drug Subutex expired in 2009, generic versions of Subutex were released. The branded drug Subutex was soon after discontinued in 2011.
In 2012, Suboxone film replaced the discontinued Suboxone tablet in an effort to reduce the potential for abuse. In 2013, the FDA approved the first two Suboxone generics. Since then, additional Buprenorphine/Naloxone (Bup/Nx) drug combinations have been approved by the FDA. A new Bup/Nx sublingual tablet, called Zubsolv was approved by the FDA in 2013. One of the latest buprenorphine prescription products to hit the market is Bunavail buccal film; Bunavail appeared in pharmacies beginning in 2014. Additional Bup/Nx medications are in clinical trial and FDA review stages and are forecasted to be released through 2015 and 2016.
Opiate Addiction Treatment with Suboxone and Subutex
Suboxone and Subutex are administered as a part of a complete treatment program under the supervision of a doctor and pharmacists and, unlike methadone, can be taken at home as a prescription medication. These drugs are almost always prescribed at the beginning of an opiate addiction treatment program and are used to mimic and replace the effects of opiates in order to reduce the dangerous and sometimes life-threatening withdrawal symptoms associated with opiate dependency.
In some cases, Subutex is only used in the first few weeks of treatment because it does not contain any ingredients to counteract dependency. After the initial stages, it is replaced with Suboxone or a similar Bup/Nx drug, which contain a synthetic drug additive called naloxone that works to prevent misuse. Suboxone is then used in the maintenance stages of treatment, and the patient is gradual weaned off the substance with minimal negative withdrawal symptoms.
Possible Subutex and Suboxone Addiction
Subutex and Suboxone are controlled substances that are FDA approved for take-home use. The potential for dependency or overdose are relatively low, with the possibility for both being much higher with Subutex as it does not contain the anti-abuse drug, naloxone. Just like opiate addiction treatment, most Subutex addiction treatment programs rely on Suboxone or other Bup/Nx management to help maintain a healthy recovery from dependency.