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Question 1

Subutex vs. Suboxone &#8211; What’s the Difference?

Accepted Answer

Subutex and Suboxone are two medications that share an active ingredient: buprenorphine. The difference between them is that Suboxone has an additional active ingredient called naloxone. Naloxone is the same medication that first responders use to reverse the effects of an opioid overdose.

Suboxone is designed to help manage opioid dependency, and the opioid-blocking ingredient provides it with a safeguard that Subutex does not contain.

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Suboxone is designed to help manage opioid dependency, and the opioid-blocking ingredient provides it with a safeguard that Subutex does not contain.

Does Subutex do the same thing as Suboxone?

Yes, both medications work in the same way. Suboxone and Subutex contain buprenorphine, a partial opioid agonist that binds to the opioid receptors in the body but produces less powerful effects than other opioids like heroin or Oxycontin. The key difference is that Suboxone also contains naloxone, an ingredient that helps lower the risk of overdose. Subutex, on the other hand, is the brand name for buprenorphine without any added blockers.

Suboxone and Subutex are used to treat opioid addiction because they lessen the effects of withdrawal while satisfying the brain’s craving for the drug. The idea is to reduce the individual’s desire to use, which is especially strong in the first few days without opioids. Once we address the physical symptoms, the patient can fully engage in their recovery by attending therapy, going to meetings and forming connections with other sober people.

Can any doctor prescribe Suboxone?

No, physicians must be registered with the FDA and obtain a waiver to prescribe Suboxone or Subutex. Even though buprenorphine is safe when used appropriately, it is still a powerful opioid medication. Buprenorphine is listed as a Schedule III controlled substance by the FDA and is tightly restricted to prevent the medication from being abused or falling into the wrong hands.

Is Suboxone more expensive than Subutex?

Looking strictly at the retail price, Suboxone is more expensive than Subutex because it contains an extra ingredient, naloxone. However, health insurance covers or greatly reduces the costs of both medications, so the price isn’t usually a deterrent for those who are insured. The most important thing is that you work with your doctor to find the medication that works the best for you and your circumstances.

Medicaid also covers buprenorphine treatment with Suboxone or Subutex. With Medicaid coverage, these medications are much more affordable. Each state has its own Medicaid program, so coverage and costs vary depending on where you live. Tennessee Medicaid, for example, requires prior authorization and proof of enrollment in substance abuse counseling.

Why do doctors prescribe Subutex if it has no opioid blocker?

Subutex is the best medication to use when beginning treatment for opioid addiction. This is when withdrawal symptoms are at their worst. Suboxone contains naloxone, and taking it too early in the detox process can make withdrawal symptoms worse. Subutex does not contain the opioid blocker Naloxone, so the patient can begin taking the medication as soon as withdrawal symptoms occur. After they are stabilized, I typically switch them to Suboxone to take advantage of the opioid blocker as a built-in safety measure. If they aren’t going to use buprenorphine as a maintenance medication long-term, we titrate the individual off while they are still in treatment.

For the most part, Subutex is used in a clinical setting, like a drug detox or addiction treatment center. There, it can be administered under the supervision of medical providers. Suboxone, though, can be taken at home.

On very rare occasions, naloxone can cause adverse reactions. In these cases, Subutex might be the best option for long term treatment. This is rare though, and for the most part, buprenorphine therapy is a safe, effective method of treating opioid addiction.

Are Subutex and Suboxone dangerous?

When taken according to the directions of the prescribing doctor, Subutex and Suboxone are considered safe medications. With that said, there is potential for abuse with any opioid, including buprenorphine. The risks are greater with Subutex since it does not include naloxone. While misuse of either drug is risky and should be avoided, most patients comply with their scheduled dosing and are successful.

Buprenorphine is considered safer than other opioids partially because of the ceiling effect. The ceiling effect means that at a certain level, taking more buprenorphine will not increase the effects. This is an important feature because it makes buprenorphine less appealing to use recreationally. Other prescription opioids, like oxycodone or hydrocodone, do not have the ceiling effect, which is one reason why they are so addictive. From what I’ve observed, the ceiling effect works. Those who are addicted to opioids tend to view Suboxone and Subutex as a means of reducing withdrawal pains, not an alternative drug used to get high.

Suboxone adds yet another layer of safety with the addition of naloxone. When suboxone is injected, the opioid-blocker naloxone activates and prevents the individual from feeling the full effects. This is meant to discourage patients from using the medication to get high. Subutex, on the other hand, does not contain naloxone.

The most important thing to recognize is that the benefits of medication-assisted treatment outweigh the risks. MAT isn’t about substituting one substance for another- it’s about using the tools available to help you get better and prevent a relapse.

Can you become addicted to Suboxone or Subutex?

The consensus is that long-term buprenorphine use could result in dependence but typically not addiction. Dependence is when a person feels like they need the medication to function, whereas addiction is a compulsion to use to the point that the medication is abused and interferes with the user’s ability to live their life. This does not rule out the possibility of an addiction to Suboxone or Subutex developing; it just means it is unlikely.

Suboxone is considered safer than Subutex when it comes to the potential for addiction. The naloxone ingredient in Suboxone means makes it less likely to be abused than Subutex.

Do Suboxone and Subutex work for opioid addiction?

Yes! Both Suboxone and Subutex are considered effective treatment options for opioid use disorders. It does need to be said, though, that they are not perfect. Some people who take Suboxone continue abusing opioids or other medications. In my experience, the greatest treatment success stories come not from medication alone, but a holistic approach that includes appropriate individual and group therapies.

Question 2

Suboxone vs. Methadone &#8211; is it the same?

Accepted Answer

While the two are similar, Suboxone and methadone are not the same medication. The active ingredients in Suboxone are buprenorphine and naloxone. For methadone, the active ingredient is methadone hydrochloride. Both medications are opioids, which means they act on the body in similar ways. Both suboxone and methadone are indicated for the treatment of opioid dependence, and in some cases, chronic pain.

Does anyone still use methadone?

Yes, methadone is still used for treating opioid addiction, and to a lesser degree, chronic pain. While it isn’t talked about as much as it once was, use is actually on the rise, likely because opioid addiction and treatment are increasing. Doctors have been prescribing methadone for decades, long before I started practicing medicine.

Most of the time, I prescribe buprenorphine-based medications because they are better for the short term. Where it can take weeks to wean off of methadone, buprenorphine can help someone overcome the initial opioid withdrawal symptoms in the short term. Medications like Suboxone and Subutex are more flexible, and therefore more practical for clinical use.

Another reason Suboxone and other buprenorphine-based medications are the better choice is that they can be prescribed by approved doctors during an outpatient visit, like you do with other prescriptions. Methadone, on the other hand, requires individuals to travel to a specialty clinic where they take the drug under supervision. Now, people in recovery can treat their opioid addiction by taking medicine at home, without the additional step of traveling to the clinic.

Is suboxone more effective than methadone?

Both medications are effective for treating opioid addiction. However, most physicians (including myself) prefer to prescribe suboxone. The combination of buprenorphine and naloxone makes suboxone a safer and more flexible medication. And, subutex and suboxone can be used both in the short-term during detox and longer-term with maintenance programs.

One study comparing the effectiveness of methadone and buprenorphine (the main ingredient in Suboxone) found that they are equally effective for treating opioid addiction.

Does Suboxone cost more than methadone?

Yes. Suboxone is a brand-name medication; methadone is a generic. As such, it costs more to access. Generic versions of Suboxone have been on the market since 2018. These are more cost-effective than the brand-name drug, yet are still pricier when compared to methadone, especially given some methadone clinics are free of charge.

Can you overdose on Suboxone and methadone?

Methadone overdose can occur and is well documented. However, that doesn’t mean that the medication is unsafe or ineffective. Most methadone overdoses happen to non-prescribed users, often when someone takes more than they are prescribed or mixes the medication with other substances.

Suboxone overdose is possible, but it’s rare. This comes down to two factors. One: it is only a partial opioid agonist. Two: it contains naloxone, which is designed to reverse opioid overdose. Because of the lower potential for abuse and overdose, suboxone is usually considered the safer medication.

Is Suboxone harder to get off than methadone?

Both are opioids, and withdrawal symptoms may occur when you discontinue taking the medication. Suboxone and methadone have a reputation for causing difficult detoxes, but the truth is that all opioids can cause these symptoms, and neither suboxone nor methadone is worse. Anyone who is discontinuing these medications should consult with their doctor to help them gradually and safely lower the dose. Following the advice of medical professionals will help reduce withdrawal symptoms and ensure a safe transition off of the medication.

Because suboxone is a partial opioid agonist while methadone is a full opioid agonist, the latter is more likely to cause dependence. Keep in mind that every person will respond to these medications in their own way, so while one is more likely than the other to be harder to stop, there are no guarantees.

Is suboxone safer than methadone?

Suboxone is considered a safer medication because it contains naloxone, an opioid blocker. Naloxone blocks the feel-effects of the opioid while the buprenorphine diminishes withdrawal symptoms. Methadone, on the other hand, does not contain an opioid blocker to counter its main ingredient.

Does suboxone interfere with methadone?

Suboxone is not prescribed alongside methadone- it’s one or the other. Taking both at the same time could cause an adverse reaction and send an opioid-dependent person into full withdrawals. If the doses are high enough. Although methadone and suboxone are entirely different medications, they are both opioids, and taking them together will significantly increase your chances of overdose. Both of these medications should only be taken as prescribed by your physician.

Category: Suboxone

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