Subutex vs. Suboxone – What’s the Difference?

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.

   Suboxone  Subutex
 Active Ingredients Buprenorphine, Naloxone

Buprenorphine

 Includes Opioid Blockers  Yes No
 Generic Available Yes Yes
 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)

 

Detox/Inpatient treatment

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.

Subutex Side-Effects

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:

  1. Buprenorphine is a partial-agonist opioid, so Suboxone and Subutex have less intense effects compared to typical opioids.
  2. People that are prescribed buprenorphine already have a tolerance to opioids.
  3. 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.

Is suboxone effective

Sources

National Center for Biotechnology Information: “Buprenorphine”
Food and Drug Administration: “Information About Naloxone”
National Institute on Drug Abuse: “How do medications to treat opioid use disorder work?”
Food and Drug Administration: “SUBUTEX (buprenorphine sublingual tablets) for sublingual administration”
National Institute on Drug Abuse: “How effective are medications to treat opioid use disorder?”

Responses

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  1. Recently I get severe nausea after taking my subutex, is there another way to take it besides under my tongue? The taste makes me vomit!

    1. Hey Dez! Unfortunately, the sublingual buprenorphine tablets only work under the tongue. The medication becomes less effective if you swallow or chew them.

      Nausea is a common side-effect with Subutex, but it should get better as you continue to take the medication and your body adjusts. If it continues, try taking your Subutex with a little food in your stomach (just don’t take it while eating). You can also try over-the-counter nausea remedies like antacids.

  2. Do you have to wait to withdraw from subutex to take suboxone like you would going straight from opioid use to suboxone?

  3. Hi! I am switching from subutex to suboxone, I have read that you can experience w/d symptoms when switching.. is that true?

    1. Hi Jennifer, most people who transition from Subutex to Suboxone maintain the same dosage and don’t experience withdrawal symptoms. That said, some people do get mild symptoms that occur a few weeks to a few weeks after they switch. If you do start to feel withdrawal symptoms, let your doctor know immediately and they can adjust the dose. Don’t try to tough it out – be honest with your doctor about how you are feeling. The most important thing is that you stay consistent and stick to your treatment plan.

  4. Following up on Julie Betts’ question, and your response… Currently taking Subutex to help get off opioids, which is also helping manage pain due to a chronic pain condition (hence the reason for being on opioids). If switched to Suboxone, would it have the same effect from a pain management perspective? Or is Subutex better than Suboxone when it comes to pain management?

    1. Hi Dean! From a pain management perspective, Suboxone and Subutex have the same therapeutic effect. You should have no problem switching from Subutex to Suboxone, but make sure you work with your doctor to come up with a plan first. Most people maintain the same dosage when they switch, but sometimes it is necessary to make adjustments. Best of luck!

  5. Why is it that I’ve witnessed people shooting up suboxone if the naloxone is suppose to be a deterrent for that reason? I’ve never done it but the guys that have say the naloxone has absolutely no effect? I’ve always heard the company that brought us Suboxone put that little bit of naloxone in there just to pass it through the FDA. They hear the naloxone is gonna keep people from abusing it so they rushed to approve it. In fact I’ve read the amount of naloxone isn’t enough to do much of anything. I’ve taken both and i can’t tell the difference. Only that the practically inert naloxone gives excruciating headaches which I too have experienced. We all know that BIG PHARMA runs this country. Also why are they able to keep the price point so high? Even the generics are sky high. Just another way to keep the addict down and out.

    1. Hi Jason, Suboxone isn’t going to give you an intense high like heroin or fentanyl. People inject it because that’s what they’ve learned to do in addiction to get more immediate relief. It has a street value because it curbs withdrawal symptoms (just like more heroin does, only in a much safer way). By taking Suboxone, people that are physically addicted to opioids can function and even feel a surge of energy as they come out of withdrawal. The Naloxone in Suboxone also helps to prevent overdose.

  6. hi Dr. Stephen, i was on 120 mgs of morphine for 2 months, i quit that with suboxone, the most i took in 10 days was 12mgs. my Dr tapered me by 2 mgs to get me off. i have been off suboxone for 4 days now but still feel very depressed and i have chills, will this go away? i didnt think i was on it long enough to feel this way. thank you

    1. Hey Matthew – Hang in there! It’s common for mild withdrawal symptoms to linger after detoxing from opioids. This is known as Post-Acute Withdrawal Syndrome. The good news is that post-acute withdrawals don’t last forever and symptoms usually taper off within a couple of weeks. Your medications and therapy can help you get through it, but if your symptoms get worse, follow-up with your doctor. Best of luck!

    1. Have you heard of either being used in a pain management setting and do you feel it is effective and of so why isn’t talked about more

    2. Hi Avraham, thank you for your comment! It’s not necessarily true that Subutex is stronger than suboxone. Both have the same active ingredient, Buprenorphine. The only difference is that Suboxone also includes naloxone, which blocks the effects of opioids.

    3. Hey Julie – great question! I have heard of cases where Suboxone and Subutex are used off-label for pain management, but this is relatively rare. The research shows that buprenorphine can help treat chronic pain, but it is generally less effective compared to traditional opioid pain relievers. That is why Suboxone and Subutex are typically used to treat opioid dependence rather than chronic pain.

      However, it’s important to note that using buprenorphine for pain relief has its advantages. For one, Suboxone and Subutex are less addictive than traditional opiates, like oxycodone or morphine. Also, the risk of accidental overdose is much less with buprenorphine.

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