Suboxone is a narcotic used to treat patients with opiate addictions. It is a combination of buprenorphine and naloxone. Buprenorphine is the opiate medication and naloxone is a special narcotic, which reverses the effects of other narcotics.
Suboxone is only approved for use in the United States as a treatment for opiate addiction, while approved in other countries for both opiate addiction and pain management medication. Suboxone shares the market with other opioid therapies such as Subutex and methadone, although treatment by Suboxone is the preferred method due to high success rates in heroin addicts.
Background of Suboxone
Buprenorphine was first marketed by the British firm Reckitt & Colman (now known as Reckitt Benckiser). It was marketed under the trade names Temgesic and Buprenex. After the successful launch of these two preparations, two additional ones were launched on the market. Subutex had no active additives, while Suboxone was made up of four parts buprenorphine and one part naloxone. Suboxone can be found in the United States as orange film strips or hexagonal white – colored tablets.
Subutex and Suboxone are available in 2mg and 8mg sublingual dosage forms, with Suboxone also available in 4mg/1mg and 12mg/3mg strengths of buprenorphine/naloxone. Since the launch of Subutex, demand was so high, Rickett Benckiser could not meet demand, and Roxane Laboratories was awarded FDA approval for a generic of the preparation in 2009. They also could not keep up with market demand, resulting in pharmacies running out.
Teva Pharmaceutical Laboratories, headquartered in Tel Aviv, Israel, also received approval in 2010 and began limited distribution in the United States to keep up with the high demand. In 2013, the Poison Control Centers in the United States released data showing that Suboxone tablets had a higher rate of accidental pediatric exposure in comparison to the Suboxone film. Rickett Benckiser voluntarily pulled their tablets off of the United States market, and only sells the Suboxone film currently.
Opioid Replacement Therapy
Opioid replacement therapy is a procedure where an illegal opioid drug is replaced with a drug containing a longer half-life, and one that does not create the heroin euphoria. The drugs of choice to replace opioid drugs, such as heroin, are methadone and buprenorphine. Although the opioid replacement drugs are also highly addictive if not taken as prescribed, they can allow the addict to regain a normal life while being treated. Also, this helps people avoid experiencing the horrific withdrawal symptoms that opioid addiction creates.
Suboxone treatment has a 40-65% success rate, particularly after the patient is treated with opioid replacement therapy and receives a maintenance therapy once withdrawal has ceased. Less than 2.5% of patients who discontinue opioid replacement therapy prematurely are able to maintain abstinence from opioid drugs, while the risk of overdose climbing to 290% in the first six weeks after prematurely ending therapy. This is a strong indication of the success that can be attributed to buprenorphine in a treatment regimen for recovering heroin addicts.
Buprenorphine versus Methadone
The two most common medications used to treat opioid addiction are methadone and buprenorphine. Both are used in short- and long-term opioid replacement and maintenance therapies. When comparing efficacy of buprenorphine (Suboxone) to methadone, treatments with buprenorphine are found to be far superior to treatment with methadone. Buprenorphine is metabolized in the liver via the CYP3A4 enzyme while methadone is metabolized by the CYP3A4, CYP2D6, and CYP2B6 enzymes.
It is not fully understood how the difference in metabolism affects the action of each drug, but it does seem to boost the action of buprenorphine (Suboxone). Suboxone is also used for pain management in other countries, where approved.
Outpatient Houston drug rehab clinics such as Inclusive Clinics offer Suboxone to patients with high success rates compared to when patients try and go “cold turkey”. The Board Certified Houston doctors provide individualized treatment to those in need of addiction treatment.