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A friend has asked me to try and find out as much as I can about the relatively new mixture of buprenorphine (subutex) and naloxone – Suboxone.
I have recieved a glossy brochure from the manufacturers, Schering-Plough, which is quite helpful. However my healthy concerns that it is a marketing tool produced by a multi-national profit led drug manufacturer were met with the quote from my friend “they are unlikely to say it is cxxp”.
And this is where the good people of the WiredIn community can help my friend to make a balanced and informed choice(I hope). Obviously my friend and I know that other peoples experiences of any treatment are likely to be different to his but, as he says, “if you are going to buy a new car it is sensible to ask previous owners what they think”
I am appealing to ALL members of this community to please share their experience of suboxone – whether you are on it, have asked for it but can’t get it, have you got a relative/friend who is and how has them taking it affected you? Have you prescribed it to some one, what have they said about it?
Are you working with a client on it, what have they said? Do you work for Turning Point, who helped in the production of the document? Please share your experiences with us all.
I hope this can be a learning experience for everyone and a real opportunity to use the resources available on WiredIn i.e. the members.
Thanks in advance.
Carl,
Have a look at this website –
http://hubpages.com/hub/Buprenorphine—Suboxone-or-Subutex—Which-Do-You-Need
I have a friend on Subutex who still abuses heroin but with Suboxon containing Nalaxone the idea is to prevent this.
I’ve pasted a few comments from the above web page below: there are loads of similar websites saying the same thing, just google it:
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Suboxone and Subutex – What’s the Difference?
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It mentions that Naloxone is an opiate antagonist.
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But
If you try to abuse Suboxone by injecting it, then the Naloxone is completely activated, and will block all of the effects of the buprenorphine. If you inject Suboxone, the Naloxone will fill the opiate receptors in the brain and not only will you not get high – you will go into an immediate and full state of opiate withdrawal.
So
The Naloxone in Suboxone makes it less likely abused, and since you probably won’t abuse it, there is no reason why you can’t take home a few weeks supply at a time.
It is my understanding that they both contain a blocker, buprenorphine on it’s own is called temgesic, i’ve used subutex when ripping and it made things worse, shuddering at the thought.
never had suboxone but i was informed they were being introduced in prison because subutex can be abused by snorting, if you’ve done your rip off opiates they smash you when snorted an 8 mg tablet can make enough lines to make £50, some proffit margin eh.
i think the effects of both are similar, the buprenorphine is the synthetic morphine and thats why it works alongside the blocker, antagonist naloxone wierd that in it, the difference is how the body injest these products, subutex can give you a buzz, suboxone is not meant to be able to be abused
Check it on the web, matt is right and is more accurate in his explanation, subutex can affect any other opiates in your system but does not contain an antagonist like suboxone, subutex is easier to abuse, you learn something new everyday.
Thanks Matt and Tony
I was talking to a colleague yesterday and he said that someone who is on suboxone can still use after they have taken it – he said they would have to wait a lot longer than you do on subutex and that “the window of oppurtunity” is much shorter for the heroin to take effect.
I am not going to say more on the subject as he knows and understands a lot more about it than me – but I will try and get him to write a blog about it.
On the subject of why suboxone is being made available – in sheffield any one new to treatment is not being offered subutex any longer just the horrible green liquid or suboxone – having been involved in a peer research project paid for by the manufacturers last year – it is because as you said tony subbys are being abused in and out of prison – maybe they and the government think this will stop drug abuse in prison – If this works I will be amazed as 20 years ago before the widespread availability of gear in jail – friday nights were party nights hooch (homemade alcohol) and weed were the cons “drugs of choice”.
Surely the desire of a lot of the jail population to have a head change (mirrored by a lot of the straight members of society on friday nights) wont change what may well change is the drug of choice!!!!!!
how do I send a private message any 1 know.
The idea of the combined buprenorphine/naloxone product is to prevent injection – on the basis that the bioavailability of the naloxone is almost zero via sublingual administration. The reality is somewhat different – many users switching from buprenorphine only (Subutex) to the combined product (Suboxone) report needing to up their dose slightly – suggesting that even when taken as intended, the naloxone has some impact on the subjective effects of the pharmacotherapy. Also – the combined product will still have some desired effect when injected. Buprenorphine has a high binding affinity to opiate receptors, and competes quite well with naloxone for said receptors. People injecting buprenorphine/naloxone combo report similar effects to injecting buprenorphine alone – with perhaps a slightly slower onset of full drug effects (not surprising given very short half life of naloxone – some naloxone will bind to opiate receptors, then drop off and be replaced by buprenorphine. Sufficient buprenorphine would have bound to receptors on initial injection to prevent any precipitated withdrawal).
Ongoing heroin injection is tricky to manage with both buprenorphine, and buprenorphine/naloxone combo product. This is because buprenorphine very effectively blockades opiate receptors, so you need to wait for your dose to wear off to really feel any heroin on top. Then, after using heroin, you need to wait until that has worn off too before redosing with buprenorphine, otherwise you risk precipitated withdrawal. This is because of the high binding affinity of buprenorphine, combined with its partial agonist properties. Precipitated withdrawal will occur regardless of the presence of naloxone. So basically – people who try and continue occasional heroin injection while on buprenorphine tend to fall off the program. If people aren’t ready to cease heroin injection entirely methadone is probably a better option.
Oh and some general comments on buprenorphine as pharamacotherapy – with or without naloxone. Compared to methadone, it seems to be less sedating and people report feeling more alert. The potential for alternate day dosing is also a plus. On the other hand, some people report intolerable side effects from buprenorphine – described variously as feeling anxious, “speedy” and/or headaches. These side effects may well drop off with time but I’ve certainly talked to many people who switched to methadone or dropped off the program in the first few days because of these effects.
wow! i am shocked i’ve was on suboxone for nearly four years and it’s never occured to me to use I was so terrified after i watched my brother and his friend use thinking that naltraxone was out of their systems that changed is it not the same thing???? I’ve heard of people using on subbies but i just couldn’t do it too scared i wouldn’t want to risk inflicting withdrawls on myself just ‘coz….Tony A i’m shuddering too!
