Subutex and Suboxone are both medications that are used to treat addictions to opioids, according to the National Library of Medicine.
Both medications contain buprenorphine. The primary difference between the medications is that Suboxone also contains naloxone.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) buprenorphine was approved in 2002 for medication-assisted treatment (MAT) for opioid dependency. MAT — medication used in conjunction with therapy — is considered the best option for treating opioid addiction based on current research and treatment models.
Buprenorphine treatment is one option for MAT. It has many benefits that make this medication a preferred option for some recovery treatment plans. These benefits include:
While MAT has been demonstrated to be an effective treatment, some people may be concerned that using an opioid-based drug to treat an opioid addiction just means that people are interchanging drugs and staying addicted. However, using MAT is not the same as swapping one drug of abuse for another.
With successful MAT, cravings for opioids and compulsive behaviors are no longer present. This means the hallmarks of addiction — drug-seeking behaviors and uncontrollable drug use — are gone.
Those taking Suboxone or Subutex will still have some level of physical dependence on opioids, just as those who take many medications on an ongoing basis do. Addiction is different than physical dependence.
Addiction is a serious disease with life-threatening consequences. Physical dependence is a normal physiological process.
Over time, the person may be slowly weaned off Suboxone or Subutex once they have a strong foothold in recovery.
MAT treatment is effective in helping people stay off dangerous drugs like heroin and fentanyl, reducing the risk for overdose fatalities, and improving outcomes for people in treatment for addiction.
When used in conjunction with therapy, MAT can be incredibly beneficial to those seeking recovery from opioid addiction.
Although Subutex and Suboxone both contain buprenorphine and work in similar ways, there are some differences that should be considered when deciding which medication is best for an individual.
Subutex contains buprenorphine.
As a partial opioid agonist, buprenorphine binds to the opioid receptors in the brain, relieving pain and preventing a person who is addicted to opioids from going into withdrawal. This allows Subutex to reduce drug cravings and prevent painful withdrawal symptoms that are normally experienced by people with opioid dependencies.
Subutex comes in tablet form that is usually taken once a day. While there is some potential for abuse with buprenorphine, it does not create the same kind of euphoric high associated with heroin and other more potent opioid drugs like oxycodone.
Some people using Subutex were able to abuse the medication by crushing and injecting it intravenously, which allowed them to get an effect from the medication that more closely mimicked the high they achieved from abusing other opiate drugs like heroin. This led to the need to address the abuse potential of Subutex, which led to the development of Suboxone.
Suboxone was developed after Subutex in response to abuse issues. While buprenorphine treatment was effective and beneficial for treating opioid addictions, the medication could still be abused and therefore could be improved.
Suboxone was formulated to contain both buprenorphine and naloxone.
Naloxone is an opioid antagonist. It blocks the effects of opioids in the brain. This has the effect of deterring abuse of the medication.
Naloxone is a medication that is used to reverse opioid overdoses. It can reverse and block the effects of opioids. While naloxone is a lifesaving medication in cases of opioid overdose, when used in conjunction with buprenorphine, the medication can prevent a person from getting high on opioids.
If an individual attempts to inject Suboxone, they will immediately go into withdrawal due to the naloxone component. This will result in distressful symptoms, such as nausea, pain, vomiting, dizziness, sweating, muscle aches, and other unpleasant side effects.
A person regularly taking Suboxone will also be deterred from relapsing on other opioid drugs. The presence of naloxone will prevent them from getting high, defeating the purpose of using other opioid drugs.
Suboxone is available as a tablet, but it also can be delivered as a sublingual film. This further deters abuse because this preparation cannot be crushed, snorted, or injected.
Studies have demonstrated that the combination of buprenorphine and naloxone creates more of a deterrent to drug misuse than buprenorphine alone. This is the primary advantage that Suboxone has over Subutex.
Both Subutex and Suboxone are effective for their intended purposes of reducing cravings, preventing withdrawal, and improving outcomes for people with opioid addictions. Buprenorphine treatment is effective and beneficial when used as prescribed and in conjunction with a comprehensive addiction treatment plan.
The primary benefit of using Suboxone over Subutex is that is has a lower potential for abuse and therefore can be an additional supportive tool for people battling addiction. Suboxone also has alternate delivery methods, such as the sublingual filmstrip, giving users more choices.
Buprenorphine treatment has some advantages over other forms of MAT, such as methadone.
Methadone was the primary option for MAT before the development of buprenorphine. It has been shown to be an effective medication to treat opioid addiction and increase treatment retention.
Because methadone does have abuse potential as well, it has to be distributed by a licensed facility. This means that people using methadone will have to make daily trips to a clinic to take their medication. Buprenorphine can be taken at home, reducing some of the inconvenience associated with methadone maintenance.
Opioid addiction is responsible for 130 deaths every day from overdoses, according to NIDA. The opioid epidemic has reached a crisis point in the United States.
Using MAT to improve outcomes for people with opioid addictions is an essential part of the strategy to combat this massive issue.”
Subutex and Suboxone represent important advancements in the field of addiction treatment.
The development of Suboxone in response to the identified abuse potential of Subutex demonstrates how medications can be continually improved to deliver better outcomes.
Both Suboxone and Subutex have given people with addictions to opioids more choices and better support.
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(February 2018). Buprenorphine Sublingual and Buccal (opioid dependence). National Library of Medicine. from https://medlineplus.gov/druginfo/meds/a605002.html
(May 2016). Intranasal Buprenorphine Alone and in Combination with Naloxone: Abuse Liability and Reinforcing Efficacy in Physically Dependent Opioid Abusers. Drug and Alcohol Dependence. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833536/
(February 2018). Medication-Assisted Treatment. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/medication-assisted-treatment
(September 2015). Methadone. Substance Abuse and Mental Health Services Administration. from https://www.samhsa.gov/medication-assisted-treatment/treatment/methadone
(January 2019). Opioid Overdose Crisis. National Institute on Drug Abuse. from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
(April 2018). Opioid Overdose Reversal with Naloxone. National Institute on Drug Abuse. from https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio