The Drug Everybody Wants to Know About: Suboxone

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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There is a news story once a week about Suboxone. A pill to treat your addiction to pills? Is that madness? Is it different than methadone? There has been a lot of press about Suboxone, so here are the basic facts about this drug.

1. Suboxone is used in the United States for the treatment of opioid addiction. Examples of opioids you know are morphine, heroin, Dilaudid, Demerol and fentanyl.

2. Suboxone is a combination of buprenorphine (the opioid-like part) and naloxone (the anti-opioid part).

3. Suboxone is available as a film or sublingual (under your tongue) tablet.

4. The naloxone part of Suboxone is not really absorbed under the tongue but is placed in this medication to discourage intravenous use/abuse. If you were to try and inject Suboxone it would put you immediately in to withdrawal.

5. Suboxone is believed to have fewer withdrawal symptoms and less potential for death (by respiratory suppression) in overdose than methadone. The overall “sobriety” rate for Suboxone at six months was 54 percent.

6. In the United States, physicians have to get a special qualification to prescribe Suboxone for detox from opioids. Detox regimens range from one day of Suboxone dosing to as long as seven weeks.

7. A study comparing Suboxone with methadone maintenance found that those taking Suboxone had significantly lower rates of illicit opioid use.

8. In the United States, Suboxone is the first drug that can be prescribed in a clinician’s office for opioid detoxification and maintenance. Methadone treatment has required a visit to a methadone clinic, while Suboxone can be prescribed as part of an office visit with a doctor.

9. Suboxone is more expensive than methadone. Though the patent for Suboxone film runs out in August 2013 we don’t yet know if a generic is going to be made.

10. Studies suggest that Suboxone is safe and effective for both mother and newborn and the incidence and severity of neonatal withdrawal and length of hospital stay was lower among newborns of Suboxone treated mothers than those treated with methadone.

Is it crazy to treat addiction to pills with another pill?

Dr O.

Suboxone film and sublingual tablets cost around $125 to $250 for a 30-day course, depending on the form and strength. Both the film and sublingual forms are considered Tier 2 or 3 medications if covered by insurance, though the film is more likely to fall under a lower copay. There is a manufacturer discount available for the film only that will reduce out-of-pocket costs by $50, allowing insured patients to pay as little as $0 per month and cash-paying patients to receive a $50 discount; click here to go to the sign-up page.

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