Subutex vs. Suboxone

Suboxone and Subutex, are drugs that both were approved in 2002 by the FDA. These drugs have been developed for opiate addiction treatment.

Before 2000 when the Drug Addiction Treatment Act was passed, the main medication used to treat opiate medication was methadone. However, also in 2000, buprenorphine was approved by the law, and it could be prescribed by physicians that have been trained and certified to treat opioid addiction by the Center for Substance Abuse Treatment.

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What Is the Difference Between Subutex and Suboxone?

There are various differences when it comes to Subutex vs. Suboxone. The primary difference is that Suboxone contains both naloxone and buprenorphine, while Subutex contains buprenorphine only. While methadone is considered a Schedule II substance, buprenorphine is considered a Schedule III substance, indicating it is a drug that has a lower potential for abuse.

As a result, buprenorphine is usually considered to be a safer medication for opiate treatment than methadone. Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. (2020 NSDUH). For this reason, amongst others, safety when it comes to prescribed medications is essential to focus on.

Even though both drugs were developed around similar times, Subutex was composed first and while it was discovered to be relatively effective in opiate addiction treatment, there will still be a tendency for the drug to be abused. Many individuals sought to inject the drug intravenously to acquire the high they became accustomed to with prescription painkillers or heroin.

Oftentimes, they succeeded in accomplishing their need, but it brought greater awareness to developing another drug addiction to address the issue of Suboxone. In Suboxone, naloxone was combined with the drug buprenorphine to discourage abuse of the medication.

The drug naloxone is also an opioid antagonist, which means that it blocks the effects of opioids at the receptor sites. If an individual injects Suboxone, that same individual will go into a precipitated withdrawal immediately, which can be very troublesome.

Another main difference between Subutex vs. Suboxone is regarding the abuse potential. Due to the presence of the drug naloxone, Suboxone might be used less likely. As a result, this might be the most ideal choice for individuals struggling with severe addictions or even individuals who had attended treatment before and then relapsed.

It’s important to understand that Subutex and Suboxone should both be utilized as a part of a greater addiction treatment program. Medication by itself doesn’t add up to addiction treatment. Those methods of addiction treatment should be utilized alongside comprehensive therapy that can address the root causes that led the patients to their initial substance abuse.

It isn’t enough to address the physical aspect of opiate addiction, as Suboxone and Subutex do. Overall, the psychological aspects of addiction must be dealt with through therapy. This ensures a patient’s sustained recovery from the disease.

The Similarities Between Subutex vs. Suboxone

Subutex and Suboxone are both brand names. Similar to any medication, these drugs can have potential side effects such as:

Constipation
Drowsiness
Headaches
Dizziness
Nausea

When comparing Subutex vs. Suboxone, there isn’t a great deal of evidence suggesting that either medication is more effective when it comes to treating opiate addiction. If both of the medications are utilized according to prescription and under medical supervision, the buprenorphine in each drug will work as it should. Therefore, alleviating opiate withdrawal symptoms and reducing cravings.

What Is Buprenorphine?

Previously used as a pain reliever, buprenorphine is a synthetic opioid and partial opioid antagonist that binds to receptors in the brain that causes reduced feelings of well-being and pain. Even though buprenorphine isn’t a full opioid, it does act like one, causing average receptor site activity. However, buprenorphine doesn’t create a euphoric state, when it’s taken as directed.

As a result, buprenorphine can prevent withdrawal symptoms, and reduce cravings for opiate drugs such as prescription painkillers and heroin. This medication has been approved by the Food and Drug Administration (FDA) to treat opioid use disorder (OUD) as medication-assisted treatment (MAT).

Similar to all of the medications utilized in MAT, buprenorphine should be prescribed as a part of an all-inclusive treatment plan that includes counseling among other behavioral therapies to provide clients with a whole-person approach.

The first medication to treat OUD was buprenorphine as it was dispensed and prescribed in physician’s offices, increasing access to treatment significantly. The Drug Addiction Treatment Act of 2000, the Comprehensive Addiction and Recovery Act (CARA), and the Substance Use-Disorder Prevention Opioid Recovery and Treatment for Patients and Communities (Support Act) stated:

Qualified practitioners were allowed to prescribe and dispense buprenorphine for the treatment of opioid use disorders (OUD) in various settings other than opioid treatment programs (OTP). This was upon the completion of specialized training.

There are several advantages when using buprenorphine in the treatment of opioid use:

Allow the patient to focus on therapy without being distracted by cravings and withdrawal symptoms
Minimize relapse since the person isn’t experiencing uncomfortable withdrawal symptoms
Help the person remain comfortable and safe during detox
Eliminate or reduce cravings for heroin and other opiates

Side Effects of Buprenorphine

Headache, constipation, nausea, and vomiting
Dilated pupils and blurred vision
Muscle cramps and aches
Drowsiness and fatigue
Disturbance in attention
Inability to sleep
Dry mouth
Palpations
Dizziness
Sweating
Tremors
Fever

Serious Side Effects of Buprenorphine

Pain, swelling, itching, and nerve damage (implant)
Neonatal abstinence syndrome (in newborns)
Pain at the injection site (injection)
Adrenal insufficiency
Respiratory distress
Dependence
Withdrawal
Overdose

Why Is Buprenorphine Used?

As mentioned previously, buprenorphine is an opioid partial agonist. It is used to produce effects such as repository depression or europhia at low to more moderate doses. However, with buprenorphine, these effects are weaker than full opioid agonists such as heroin or methadone.

When buprenorphine is taken as prescribed, it is deemed effective and safe. It has unique pharmacological properties that can help:

Diminish the effects of a person’s physical dependency on opioids, such as cravings and withdrawal symptoms
Lower the potential for misuse
Increase safety in overdoses

How Does the Buprenorphine Process Work?

Before beginning the buprenorphine process, an OUD patient must abstain from opioid use for at least 12-24 hours and also be in the early stages of opioid withdrawal. When patients have opioids in their bloodstream or aren’t in the early stages of withdrawal, they might experience an acute withdrawal.

Once the patient has greatly reduced or discontinued their opioid use, is experiencing few or no side effects, and is no longer having cravings, the dose of buprenorphine can be adjusted. Due to the long-acting agent of the drug buprenorphine, once the patients are stabilized, it might be a possibility to switch from a dose every day to alternate-day dosing.

The length of time that a patient receives buprenorphine is tailored to meet the needs of every patient and in a few cases, treatment can be unknown. In order to prevent possible relapse, people can engage in continuous treatment with or without MAT.

How Is Buprenorphine Used?

It must be used carefully. The doctor will begin by prescribing a low dose of buprenorphine for the patient to begin taking after their withdrawal symptoms begin. Overall, the dose levels can be adjusted as needed. It is vital to take the doses exactly as prescribed.

Upon first taking buprenorphine, the patient might experience drowsiness. During this time, it’s advised that the individual taking buprenorphine doesn’t drive or perform high-risk activities till it’s known how the medication will affect them. However, if drowsiness continues to be an issue, the doctor might adjust the dose levels.

You are able to take buprenorphine for days, months, or even years – as long as it’s needed to avoid or prevent relapse. If you have liver disease, it’s best to check in with your doctor.

Once you become stable on your road to recovery and would like to stop taking buprenorphine, you must slowly get off of the medication. This process is called tapering. Tapering works the best with a substance abuse treatment provider or doctor after the progress has been made.

Is Buprenorphine Helpful for People in Treatment?

The drug buprenorphine is extremely helpful for people in addiction treatment. It is a powerful analgesic that has a long history of use in treating chronic pain and acute pain. Even though the sublingual form of buprenorphine hasn’t been approved yet for chronic pain, there are physicians that are making use of the drug off-label.

It’s possible that buprenorphine might offer an alternative to managing chronic pain that is considered more tolerable and safer than other medications. Overall, the use of buprenorphine as a pain control medication will continue to be explored in future research.