Subutex and Suboxone: Treatment for Recovery From Opioid Use Disorders

Subutex and Suboxone are both medications that have been proven to assist individuals in treating their opioid dependence. Both of these drugs have been approved by the Food and Drug Administration as of 2002. Typically, these medications will be prescribed to those who are participating in a medication-assisted treatment (MAT) program, where they take the treatment while also undergoing evidence-based therapies at the same time. 

Sometimes an individual only needs to be on Subutex or Suboxone for a few weeks, but sometimes they need to be on it for up to a few years. How long you have to stay on it depends on several factors, such as the history and severity of your opioid addiction, the severity of your symptoms, and any underlying mental health conditions that you may have.  

Opioid Addiction and Dependence

Opioid drugs are a specific class of drugs including prescription narcotics as well as non-prescription narcotics, like heroin. Even when they’re prescribed by a medical professional, opioids have a high potential for addiction and dependence. Addiction and dependence are both serious risks associated with opioids, but they’re two different concepts. 

Addiction refers to the psychological or mental aspect of the disease. Signs and symptoms of addiction may include compulsive drug use, continued drug use even after experiencing negative consequences, and the drug use appears to be out of control. 

Dependence refers to the physical aspect of the disease, occurring when the body goes into shock when you suddenly stop using a drug after continuing regular use for a prolonged period of time. The most common sign or symptom of opioid dependence is withdrawal. 

Withdrawal: One of the Many Risks of Abuse & Misuse

The severity of withdrawal can range from mild to severe discomfort, depending on several factors, including length of drug use. This is one of the main reasons that people struggle to stop taking opioids. Individuals undergoing withdrawal may experience several symptoms, some of which could include muscle cramps and muscle aches, flu-like symptoms, anxiety, nausea, and vomiting. 

Subutex and Suboxone are two examples of opioid medications that may be prescribed to help alleviate or reduce these symptoms. These drugs are often combined with a more conventional drug treatment program. These two substances have both similarities and differences. 

Comparing the two 

The main difference between these two opioids is that Suboxone is made up of both buprenorphine and naloxone, while Subutex is only made up of buprenorphine. Therefore, the most significant difference between Subutex and Suboxone is the active ingredients that they are made up of. Before the FDA approved these substances to be prescribed to aid in the treatment of opiate addiction, methadone was the primary medication prescribed. 

Buprenorphine is a partial opioid agonist, meaning that it still activates the opioid receptors in the brain but to a much lesser extent. Which is why you don’t experience cravings or withdrawal symptoms when you take these medications. Naloxone, found only in suboxone, helps prevent the abuse of buprenorphine by blocking opioid effects if someone attempts to get high by injecting or snorting it.

Methadone is a Schedule II substance and buprenorphine is a Schedule III substance. Therefore, buprenorphine treatment has a lower potential for misuse, as well as a lower potential for opioid overdose. Because of this, buprenorphine is considered to be safer than methadone when treating opiate use disorder. In 2012, certified physicians wrote 9.3 million prescriptions for buprenorphine-based medications. 

Some physicians may begin an individual’s treatment with buprenorphine and then transition into treatment with Suboxone. Studies have shown that both of these medications do improve an individual’s chances of successfully overcoming addiction. However, they are both associated with some risks and they should only be taken under close supervision of a medical professional that is experienced in the addiction recovery process. 

Which One Is better?

Although Subutex is found to be relatively effective in treating opioid addiction, there was still a tendency to abuse the drug. They were able to do this by injecting the drug intravenously to achieve the high that they were looking for. Oftentimes, they were successful. Making the development of Suboxone even more important.  Also, just like with any other opioid drug both Subutex and Suboxone may cause dependency and addiction.

Available Forms & Doses

Because of its potential for abuse, Subutex is usually only prescribed in hospitals and detoxification facilities. On the other hand, Suboxone can be prescribed by your health care practitioner in the office or even over telemedicine and taken at home. 

Suboxone is available in the form of buprenorphine-naloxone tablets or films; neither is more effective than the other. Both forms are available in 4mg, 8mg, and 12mg dosages. Subutex is also available in both forms, but they’re only available in 2mg and 8mg dosages. 

Both forms of the drug should be taken by placing the film or the tablet under the tongue and leaving it there for about 15 minutes. These types of tablets are also known as sublingual tablets. During this time the individual should not eat or drink. These drugs are also not intended to be cut, chewed, or swallowed. When taken properly, they will affect opioid receptors in the brain for up to 35 hours. 

Switching From Subutex to Suboxone

One study evaluated patients that switched from taking buprenorphine alone to taking the combination of buprenorphine and naloxone. The study was made up of 64 patients who were dependent on opioids and had transitioned from taking Subutex to Suboxone. 

At the end of this study, researchers were able to conclude that when a patient is transferred from a high daily dose of buprenorphine, which is anything over 22mg, to the combination of buprenorphine combined with naloxone, dose adjustments may be necessary. This is especially true later in the treatment. 

Because of this, it is recommended that the transfer from Subutex to Suboxone should be discussed and planned with the patient in advance, after they are transferred the patient should be closely and regularly monitored for adverse events. 

Frequently Asked Questions

Both Subutex and Suboxone are treatments for opioid use disorder (OUD). They act on the same opioid receptors in the brain as other opiates, so they help reduce cravings and other uncomfortable symptoms. They may cause similar long-term health issues, including dry mouth..
If your doctor switches you from Subutex to Suboxone or vice versa, he or she will just switch out one drug for another. As long as you are taking it as instructed by your health care practitioner, you should feel about the same overall.
Typically, you need to wait at least 12 hours after your last dose of an opiate before starting Suboxone as a way to treat opioid addiction.
Because Subutex (buprenorphine) and Suboxone (Subutex/naloxone combination) are partial opiate medications that act to block pain receptors, these drugs can be an attractive option when treating long-term chronic pain disorders. Compared to opioid painkiller drugs, long-term use of Subutex and Suboxone has a lower risk of developing physical dependence and less severe opioid withdrawal symptoms when usage stops.
Yes, buprenorphine can make you feel drowsy. Subutex can lead to drowsiness and slower reactions, particularly during the first few weeks of use. Because of this, you shouldn’t be driving, operating heavy machinery, or performing any other dangerous activities until you’ve learned how the drug affects you.
Yes, both of these medications are opioid based and work on the same opioid receptors as other narcotics. Many patients begin an MAT regiment with a hope of quickly addressing their illicit opioid addiction, but they become dependent on the replacement, such as Suboxone or Subutex.

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