To answer wait2long's question from another thread "why aren't Benzo's allowed with Suboxone & Subutex?":
Between the time my doctor suggested I begin Suboxone to the time I started, I read EVERYTHING I could find online about it. I waded through some pretty heavy medical stuff, medical dictionary in my lap. While certainly no expert, I think I'm pretty well-read on the subject.
As I recall, I read an explanation of the "No Benzo's" rule in the PDR and other sources as well. This is my understanding of it:
Buprenorphine, the active drug in Suboxone and the only drug in Subutex, has been around for many years. It was used only for pain, usually postoperative, and was only available in injectable form. Only in recent years has its value as an opiate detox drug been recognized.
As usual, it was used in European countries long before our FDA approved it for detox and maintenance. Americans are usually the last to get new, useful drugs. In the beginning of the AIDS crisis there were several new drugs being used in Europe successfully, but the FDA said "too soon, we're not done testing!" That's when the "Fast Track" program began, to force the FDA to speed things up and get important new meds to Americans who needed them.
Before Suboxone and Subutex was being used in US, it seems two or three junkies in France died from shooting up huge quantities of buprenorphine along with huge quantities of a Benzo. That is the only explanation I have read. I told my doctor this, what I had read, and he didn't tell me I was wrong; all he said was "well, it's against the protocol."
My conclusion is that's how the "Big Benzo Rule" began, from the FDA looking at a couple of cases in France. So with one stroke of the pen, they disallowed all Benzo's from the Suboxone program, before they would be willing to approve it. The FDA didn't want it in the first place, but received so much pressure from addiction specialists, they gave in. Another thing the FDA did at that time was change buprenorphine from a Schedule V to a Schedule III controlled substance. The drug certainly didn't change, just the FDA's attitude.
My doctor knew I was in no danger taking Suboxone along with 1.5 mgs. of Xanax a day. He knew I wasn't an IV drug user, and that Suboxone contains naloxone, which precludes IV abuse. But he wasn't happy about it, knowing he was breaking the rules. This went on for about a year and a half, and I tested positive for Benzo's every time. I was about ready to end the Suboxone program, because I was down to 2 mgs. a day (I began with 16). Finally he said "choose one or the other, I just can't give you both anymore. It's against the rules and I could loose my DEA license." I ended Suboxone a little sooner than I planned, but it wasn't as bad as I thought it would be, coming off of 2 mg./day.
Another comment about buprenorphine in France: there it's used in liquid form, put under the tongue with an eyedropper. It's absorbed much better that way, so patients there require lower dosages. I guess the FDA doesn't trust us to measure drop-by-drop, we're too stupid, and so we get tablets.
So, if anyone reading this is into IV drug use, and you have a whole lot of pure buprenorphine and a whole lot of Benzo's, don't shoot it all up together! You might die! Du... (That’s my sarcastic dig at the FDA, the SOB's!).
I took Suboxone and Xanax together every day for a year and a half. I don't believe I risked my life in the least at any time. I can't help but wonder if the FDA's true attitude about Benzo's is: "Well, okay, we'll let the junkies have their Suboxone, but we can't have them being too comfortable, can we? They deserve some anxiety for becoming addicted in the first place. They can't be trusted with any controlled substance; after all, they're addicts!" In other words, we're being punished.
Just one man's opinion,
Marc