Opioid use disorder reached an alarmingly high rate of occurrence in the early 2000s, prompting the FDA to approve various medicines that could be used to treat those affected. In previous years, methadone was the primary medication being prescribed to treat opioid addiction until 2002, when buprenorphine was also approved and added to the Drug Addiction Treatment Act. Around this time, Suboxone®, a combination of buprenorphine and naloxone, and Subutex®, a branded version of buprenorphine, were also added to the list of treatment medications that trained physicians were certified by the Center for Substance Abuse treatment to prescribe to those in need. This opened the doors to different methods of dealing with the ever-growing opioid crisis across the country.
How it Works
Both Suboxone® and Subutex® work to eliminate the effect of opioids on the brain and are available as sublingual film or sublingual tablets respectively. They ease the symptoms of withdrawal, which can often be painful and make it very difficult to cease drug use. The main ingredient, buprenorphine, was initially used as a pain reliever, but actively works in these medicines as a partial opioid antagonist that binds with opioid receptors in the brain providing the withdrawal symptom relief. Since it’s only a partial opioid, it still acts like one in its ability to activate the receptors, but it doesn’t evoke a euphoric high for the patient. Its’ primary purpose is to reduce cravings and stave away withdrawal symptoms making it easier for the patient to focus on recovery. The DEA has methadone as a schedule II substance, while buprenorphine is schedule III, with less potential for abuse; therefore, it has been deemed a “safer” method of treating opioid addiction by some addiction specialists.
Suboxone® vs. Subutex®
The main difference between these two medicines is that Suboxone® contains naloxone; Subutex® only contains the active ingredient of buprenorphine. Naloxone is an opioid antagonist, or blocker, meaning it blocks opioids from adhering to the receptors at all. While buprenorphine activates receptors, naloxone does not. This means that the patient cannot achieve a high from opioids while taking naloxone, and if Suboxone® is not taken as directed and injected instead, naloxone becomes activated, and the patient will immediately feel withdrawal symptoms that cannot be reversed by taking more opioids
Subutex®, as a branded version of the generic buprenorphine, was formulated before Suboxone® but, treatment efforts showed that there was still potential for misuse with Subutex®. There was a need for a treatment medicine that could curb those instances. The addition of naloxone in Suboxone® decreases the chances of misuse and also helps patients who suffer from chronic relapse. Both medications are equally as effective when taken as prescribed by a medical provider. Functionally, there is no difference when taking Suboxone® or Subutex® unless the naloxone in Suboxone® is activated due to misuse.
Patients who are recommended to take the buprenorphine only product or are prescribed Subutex® are often given the generic buprenorphine in lieu of the branded version as both are equally effective.
As with all medication-assisted treatment, Subutex® and Suboxone® are only part of an overall treatment that addresses the various dimensions of opioid use disorder. Both medications are very safe and effective when used as prescribed, and can be a pivotal step for those looking to enter recovery.