Withthe public health crisis of opioid addiction and overdoses taking our societyby storm, 2022 marked the first National Fentanyl Awareness Day in America. The U.S. DrugEnforcement Administration (DEA) calls fentanyl the single deadliest drugthreat our nation has ever encountered. It stands alongside morphine, heroin,hydrocodone, and many other opioid drugs with a long history of addiction andoverdose risks.
Raisingawareness of these deadly drugs includes the information needed to avoid thesedrugs and the importance of detoxing from them if people are addicted to them.But with multiple methods of opioid detox available, what are the differencesbetween them? Here are the differences between Suboxone and Subutex, twomethods of opioid detox treatment, and how they each have risks and benefits.
Respecting the unique nature of opioidaddiction is crucial to understanding the detox process. Recreational drugs like alcohol affect thenervous system in a specific way, often leading to physically dangerouswithdrawal symptoms. Opioids, on the otherhand, can be used as recreational drugs and prescription medications to treatpain symptoms, especially after surgery. The drug is highly addictive and cancome in various forms, from liquids to solids, powders, and pills. Effects onthe body include the inhibition of muscle movement, slow breathing, loss ofconsciousness, and possible death, especially after an overdose.
The DEA states that opioids are Schedule IIdrugs, meaning they have ahigh potential for abuse, including psychological and physical dependence. Therisk of this dependence includes the possibility of long-term use, prescriptiondosage abuse, and the need for higher dosages to experience the drug’s euphoriceffects, which highly increases the risk of overdose and death. This highlightsthe need and seriousness of opioid detox and addiction treatment. But whatoptions are available?
Suboxone is praised as the mosteffective way to treat opioid addiction. Suboxone is a combination ofbuprenorphine and naloxone. Surprisingly, these are both specific types ofopioids, but they function differently from other examples like fentanyl orheroin. Street drugs and prescription varieties of opioids are full opioidagonists, which means they bind to the opioid receptors in our brains andproduce euphoric effects almost immediately. This is a big part of what makesopioids so addictive. But Suboxone is a partial opioid agonist, which partiallyactivates in the brain instead of fully. In effect, it works to dissipatewithdrawal symptoms without activating the euphoric sensations that make otheropioids so addictive. It is worth considering the differences betweenbuprenorphine and naloxone, Suboxone’s active ingredients.
Naloxone is mainly usedto reverse an opioid overdose. When a medical emergency ensues, such as someonepotentially overdosing from fentanyl or heroin, first responders use naloxoneto save lives. It is one piece of the recovery puzzle, but it is the first lineof defense to protect people from an accidental overdose of opioids. But whatabout buprenorphine?
Unlike other opioids, Subutex or buprenorphine is a ScheduleIII drug. Its approved use is focused on pain and especially opioid addiction.Subutex came on the market in the aftermath of mixed views on the previousmethod of opioid addiction treatment, methadone. The Substance Abuse and MentalHealth Services Administration (SAMHSA) considers the drug a safe and effectivetreatment for opioid addiction when taken as directed. However, unlike Subutexand Suboxone, methadone is a fullopioid agonist, meaning its abuse potential is higher.
After concern began to grow over the abusepotential of a drug designed to treat drug abuse, Subutex was introduced as asafer alternative, especially as a transitional medication to help people withchronic addiction to potent opioid drugs. Part of this is because Subutex actsto cause a slow and steady decline from the full agonist effect of opioids andwithdrawal onset. Effectively, taking Subutex over time can create a disincentive in thebrain to continue opioid use beyond medical treatment during thedetox process.
Suboxone and Subutex were introduced assafer, more effective alternatives to dealing with opioid addiction thanmethadone. However, Suboxone, Subutex, and even methadone have their place inthe complex issue of opioid addiction. The important thing to note is how eachdrug can deal with issues specific to each patient. Addiction may come withsimilar experiences, but each person deals with opioid addiction differently.This not only includes the kind of withdrawal symptoms they experience but alsowhat method of medication-assisted treatment (MAT) is best for them. Studiesshow that Suboxone might be the best overall (and underused) drug to addressopioid addiction, but even these studies show that the level of success cannormally include Subutex in a maintenance dose before undergoing Suboxone treatment.
At the end of the day, it is importantto avoid myths about thesedrugs and instead consider that opioid treatment is tailored to eachindividual’s needs. The ongoing interaction with a trained medical professionalcan have the benefit of adjusting treatment plans as needed throughoutrecovery.
If you or someone you know is strugglingwith opioid addiction, it is best not to get caught up in whether Suboxone orSubutex is better. Instead, knowing what to expect with each of these drugs canhelp inform and prepare us to complete opioid detox and experience fullrecovery from these dangerous drugs.
DEA. (n.d.)Fentanyl Awareness Day. Retrieved https://www.dea.gov/fentanylawareness
Delphi HealthGroup. (n.d.). Guide to Alcohol Detox: Severity, Dangers, and Timeline.Retrieved https://delphihealthgroup.com/alcohol/detox/
DEA. (2020,April). Drug Fact Sheet: Opium. Retrieved https://www.dea.gov/sites/default/files/2020-06/Opium-2020_0.pdf
DEA. (2018, July10). Drug Scheduling. Retrieved https://www.dea.gov/drug-information/drug-scheduling
Delphi HealthGroup, (n.d.). Guide to Suboxone – Medication-Assisted Treatment, Abuse Risksand More. Retrieved https://delphihealthgroup.com/opioids/suboxone/
U.S Department ofVeterans Affairs. (n.d.). Opioid Overdose. Retrieved https://www.mentalhealth.va.gov/substance-use/overdose.asp?utm_source=google&utm_medium=cpc&utm_campaign=search-va-naloxone&utm_term=naloxone.narcan&utm_content=naloxone_search_ad3&gclid=CjwKCAjwkaSaBhA4EiwALBgQaLDp03EyXzNAUFBx0Uz2RoH_z77VCkGE4R0M_gf8rmteduTd81SQQBoCbjMQAvD_BwE
DEA. (2022 May.).Buprenorphine. Retrieved https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf
SAMHSA. (2022,March 4). Methadone. Retrieved https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone
University ofArkansas Psychiatric Research Institute. (n.d.). What is Buprenorphine?Retrieved https://psychiatry.uams.edu/clinical-care/cast/buprenorphine/
NIH. (2018). The OchsnerJournal: Suboxone Rationale, Science, Misconceptions. Retrieved https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/
Harvard HealthPublishing. (2021 October 7). 5 Myths About Using Suboxone to Treat OpiateAddiction. Retrieved https://www.health.harvard.edu/blog/5-myths-about-using-suboxone-to-treat-opiate-addiction-2018032014496