Subutex and Suboxone are medications that share an active ingredient: buprenorphine. The difference is that Suboxone has an additional ingredient called naloxone. Naloxone is the same medication that first responders use to reverse the effects of an opioid overdose.
Subutex can be taken immediately after drug use, whereas the blocker in Suboxone can make immediate withdrawal symptoms worse.
|Active Ingredients||Buprenorphine, Naloxone||
|Includes Opioid Blockers||Yes||No|
|Delivery||Oral, Sublingual||Oral, Sublingual, Monthly Injection, Implant|
|Brand Names||Suboxone, Zubsolv||Subutex, Sublocade, Belbuca, Probuphine|
|Most Common Uses||
Outpatient treatment or at home (with prescription)
What is Subutex?
Subutex is a medication used to treat opioid addiction. The generic name for Subutex is Buprenorphine. Subutex satisfies the opioid receptors in the brain that are craving drugs, which alleviates withdrawal symptoms.
Doctors use Subutex during the detox process to get the patient off of opioids without sending them into full withdrawals. Usually, this is done in an inpatient detox facility, where staff can monitor the patient as they taper off of the medication over a few days. The goal is to slowly lower the level of opioids in the patient’s system so that they don’t experience the overwhelming withdrawals that lead to relapse.
While buprenorphine doesn’t take away withdrawal symptoms entirely, it makes it much easier to convince people to get help. Detoxing from opioids is uncomfortable, but it doesn’t last forever, and medications like Subutex can help get you through.
Does Subutex do the same thing as Suboxone?
Yes. The point of both medications is to alleviate withdrawal symptoms and reduce cravings. The active ingredient in Suboxone and Subutex is buprenorphine, a partial opioid agonist. Buprenorphine satisfies opioid cravings but produces less powerful effects than other opioids like heroin or Oxycontin.
Why do doctors prescribe Subutex and Suboxone?
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.
When is Subutex used?
For the most part, Subutex is used in a clinical setting, like a drug detox or addiction treatment center. At treatment facilities, Subutex is administered under the supervision of medical staff. Suboxone, though, can be taken at home.
Can any doctor prescribe Suboxone?
No, physicians must be registered with the Food and Drug Administration 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?
The retail price of Suboxone is about $200 for (30 day supply) and Subutex is $160 for 30 days. Suboxone offers this coupon to significantly reduce the price per month.
Health insurance (including Medicaid) covers both medications. If you have insurance, it is just a copay- usually $25 per script. Most insurances require therapy to authorize the medication, which would be a separate cost.
You can’t substitute Subutex for Suboxone just because it’s cheaper. Unlike Suboxone, Subutex would rarely be given at-home or long-term.
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.
Are Subutex and Suboxone dangerous?
Research shows more people are willing to accept treatment only if these medications are included because they significantly improve withdrawal symptoms and reduce mental cravings. It’s a way to get more people help and meet the struggling person where they are at.
While there is potential for abuse, Suboxone and Subutex are only partial opioids. That means there is a ceiling effect, which:
- will not get you high like other opioid medications
- is less likely to cause overdose
- does not increase effects with higher doses
Suboxone is safer than Subutex because naloxone further blocks the full opioid effects.
Why is there naloxone in Suboxone?
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.
Can you become addicted to Suboxone or Subutex?
It is possible to get addicted to Suboxone or Subutex, but it’s not common. Here’s why:
- Buprenorphine is a partial-agonist opioid, so Suboxone and Subutex have less intense effects compared to typical opioids.
- People that are prescribed buprenorphine already have a tolerance to opioids.
- The Naloxone in Suboxone adds another layer of safety by helping to prevent overdose
People who are already addicted to opioids won’t feel high from buprenorphine because they are already opioid-tolerant. Because the effects less intense, taking Suboxone and Subutex satisfies the craving without reinforcing addictive behavior.
Is Suboxone safer than Subutex?
Suboxone is considered safer than Subutex when it comes to the potential for overdose. If someone tries to inject Suboxone, the naloxone will partially block opioid receptors and reduce the chance of overdose less than Subutex. However, both are generally considered safe, especially when administered under the care of an accredited addiction treatment facility.
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.