Subtex vs suboxone

[Quki73]

What is the difference with subtex and suboxone? Why would a Dr refuse to prescribe me subtex over suboxone for pain management if I have never admitted or reported or been caught as an opiate addict?

[Julia M Aharonov, DO]

Suboxone is the brand name for a medication consisting of buprenorphine and naloxone. Buprenorphine is a thebaine derivative with powerful analgesia approximately 20-40x more potent than morphine. Buprenorphine is a partial agonist and antagonist of the opioid receptors in the central nervous system which means that when its molecule binds to a receptor, it will transduce only a partial response in contrast to a full agonist such as morphine. Buprenorphine has such a high affinity to the opioid receptors that the opioid receptor antagonists (e.g. naloxone) only partially reverse its effects. This means that an overdose of buprenorphine cannot be easily reversed. Naloxone is opioid receptor blocker (antagonist). They are combined together to prevent inter-venous abuse of this medication. In the US, Suboxone has been approved by the FDA for the treatment of opiate drug addiction. However many individuals who start using it to treat their addiction, become addicted to the Suboxone itself. Suboxone has a high rate of illicit abuse.
Subutex, the product containing buprenorphine alone with no naloxone, creates a greater risk of misuse, abuse and diversion and many physicians are uncomfortable prescribing it. I hope this was helpful.

[Quki73]

Thank you! I just  don't understand how I can abuse something that does not produce a high? I take just enough suboxone so that I don't go into WD or experience chronic pain- so I can function.  I am not an IV user and don't plan on becoming one.
I'm wondering If the Naloxone mixed with Prozac and Topamax are causing my depression to worsen?
I'm trying to minimize my medication intake.