What is the differnce in Suboxone and Buprenorphine for Hydrocodone withdrawals?

[bamagirl1959]

I was addicted to Loratab from 1999 until May 7th, 2002, my intake daily was about 23. On May 7th, 2002 I took my last one and went cold turkey and by the grace of God stayed clean for 5 years. About 9 months ago I took a very bad fall and went to my doctor and now he has me on Loracet 10mg. 4 times a day, but I take 5 a day and let me mention that I also have Fibromyalgia. I want off of these things again, but I know I can't go cold turkey again. I knew a young man who took about 15 a day and went to a local doctor here in Birmingham, Alabama and the doctor put him on Suboxone and it worked for him, but now after I've read all the good and bad about Suboxone I'm wondering what to do. I read about a medicine that is said to be better called Buprenorphine and was wondering if anyone could give me some information on this. Thank you very much, Cathy

[J T Junig, MD PhD]

I have to make a rare correction, Eagle-- Suboxone has naloxone, the IV form of naltrexone.  I'm sure you have the principals down though--  naloxone is completely irrelevant to the action of Suboxone, and is there for show more than anything-- it does nothing to contribute to the actions of the drug, but is used to deter people from injecting Suboxone, since then the naloxone would be active.

Eagle is correct, Cathy-- buprenorphine, Suboxone, and Subutex are all essentially identical.  Buprenorphine has been around for 30 years;  it used to be sold under the brand 'temgesic' in liquid form before being made as Suboxone, which is easier to dose.  Buprenorphine is used for pain, mostly in Europe-- a skin patch in the UK called 'buTrans' releases 5-20 micrograms of bupe per hour through the skin.  

Six years ago, in 2003, Suboxone became available in the US.  It was initially marketed for tapering off opiates, but since that time a number of studies and obvious clinical experience has shown that people who use it short-term almost always end up back where they started.  Now, over 70% of scripts are written for long-term use, as a maintenance agent.  Some people will take a couple doses of Suboxone and then stop, and that will blunt withdrawal a bit.  But the non-linear dose-response relationship makes it a hard med to use for a taper.  It is also too potent to taper well;  if taken efficiently, a quarter of a tablet has about the same opiate potency as a whole tablet, so it is hard to taper by taking smaller and smaller pieces.

Most of the horror stories are not accurate;  I go into the reasons behind them on my blog, if you are interested (suboxonetalkzone.com).  A couple quick points-- 'current' pain is always worse than 'remembered' pain;  also people always forget just how miserable opiate withdrawal is.  I frequently point out that people coming off buprenorphine keep going to work and talking about their misery;  people coming off methadone or oxycodone lie in a bed at home or in a detox center or hospital, legs kicking, with no possible way to even think about going to work!  Methadone withdrawal is known by most people to last for several months-- buprenorphine withdrawal is less severe and lasts for about a month, and people talk as if that is worse than other opiates!  I'm not sure if they have just forgotten or if maybe they never experienced real agonist withdrawal.  I have seen people come of both, many times, and there is no doubt in my mind that I would rather come of Suboxone than methadone, fentanyl, oxycodone, or even codeine.

[122 Tactical Fighter Group]

You are getting phamocologically confused with your frantic search for an answer.   Suboxone is a compuond containing BUPRENORPHINE  and  NALTREXONE  - - - Subutext contains only Buprenorphine.   Both are used to treat opiate problems.

[Nikon1]

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