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Suboxone and Subutex are FDA-approved medications used to treat patients with opiate addiction through what is called opiate replacement therapy (ORT). Both drugs have the same active compound, known as buprenorphine. Buprenorphine works by stimulating the same brain cell receptors opiates also influence, without causing the psychotropic effect known as a “high.” This allows opiate addicts to stop using opioids such as OxyContin, Vicodin and heroin, without experiencing withdrawal symptoms and cravings.
Essentially, buprenorphine helps opiate addicts stabilize by tricking the brain into experiencing an opiate. Without buprenorphine, normal brain chemical levels can’t stimulate the brain cell receptors necessary to prevent dysphoria, resulting in withdrawal symptoms.
Because it mimics opiates, opiate addicts using buprenorphine to rehabilitate have the potential to abuse the medication. Buprenorphine is unlikely to cause overdose even in high doses, and it does work to treat opioid addiction. However, there’s still a tendency to abuse this drug.
Subutex is a drug that contains buprenorphine as its only active ingredient. It was developed before the creation of Suboxone, which was later developed in response to the issue of Subutex’s misuse. Suboxone contains another active ingredient besides buprenorphine, called naloxone. Naloxone is the active compound in the drug Narcan, used to reverse drug overdoses. Naloxone staves off buprenorphine misuse by preventing the high that comes from taking opiate drugs, and by causing severe withdrawal symptoms to occur when combined with an opioid. This state of withdrawal is intense and can’t be reversed by taking an opioid drug.
When no opioid is taken, naloxone produces no effect. Thus, Suboxone works the same way as Subutex as long as opioids are avoided. Compared to buprenorphine taken alone, buprenorphine combined with naloxone has been shown to prevent relapse when patients are sent home from rehabilitation. That’s why Suboxone is typically prescribed for take-home doses and is considered more suitable for recovery than Subutex.
Patients who experience Suboxone treatment for opioid addiction even after the detoxification period have a lower rate of relapse, according to studies, thanks to it deterring the use of opiate drugs. It’s recommended to be taken for about a year after initial treatment, during which time patients should also address the psychological component of their addiction. Suboxone does not cause dependence and treatment with it can be stopped with minimal side effects. However, the dosage is usually tapered off before being completely stopped. Treatment is typically stopped after a year—you don’t have to take it the rest of your life.
During the initial detox process in early opioid addiction treatment, doctors sometimes opt for Subutex instead of Suboxone when the patient is under supervision in a rehab center. Compared to Suboxone, Subutex causes a more pleasurable reaction in opioid addicts, especially when injected, as it better mimics the action of opiates in the brain. Because the effects increase when Subutex tablets are dissolved and injected, they have a chance of being misused when prescribed for home use.
While Suboxone prevents opioid withdrawal symptoms, it doesn’t mimic opiate drugs as much as Subutex. However, it drastically reduces the risk of relapse, which is why it’s a better option for people who are serious about recovering from opioid addiction. Suboxone allows addicts to focus on their recovery, knowing they won’t be able to get high while they’re on the drug, even if they take an opioid. However, patients can get high from taking non-opiate drugs while they’re on Suboxone, which sometimes occurs out of desperation. That’s why opiate replacement therapy should always be combined with other treatments, including psychological rehabilitation with the help of qualified professionals.