Subutex is a medication from Reckitt Benckiser. It is an opioid agonist-antagonist and it is used to treat opioid addiction. This medication is used for detoxification from opioid drugs as well as for long-term “maintenance” treatment for those unable to stay clean form opioid drugs. In this way it is similar to methadone maintenance.
When a patient is not wanting to go to methadone maintenance treatment, they can use Suboxone or Subutex as another option. Both Suboxone and Subutex both contain buprenorphine, but Suboxone also contains the medication Naloxone. The addiction of Naloxone in Suboxone make it less abusable.
Because Subutex does not contain the naloxone, we have found higher abuse rates with this medication. One can get an effect from Subutex by using it IV while Suboxone will not work if injected. The parent company Reckitt Benckiser sent out letters to doctors recently indicating it was stopping production of the brand name Subutex because of this abuse potential. They did say the medication would still be available from other generic drug companies.
Is The Discontinuation of Subutex a Big Deal?
Mostly no. Since the generic from of Subutex can still be prescribed, if a patient really needs this medication, they will be able to get it by prescription. On the other hand, the letter sent out to physicians regarding the abuse potential of Subutex may discourage some doctors from prescribing this medication. I suspect they will think twice before prescribing it to patient.
This is probably a good thing. We have now have the Suboxone film and the longer acting formulatios are being developed. If we look at Methadone, we can see the abuse potential of Subutex. The reason be still use methadone is because we don’t have a good alternative for certain patients.
How I Use Subutex
I’ve only given Subutex several times to patients. Once was because of an allergic reaction to suboxone. The other few times I quickly became concerned about the abuse issues with this medication in my patients. They all eventually got off the medication. At this time I try to discourage the use of Subutex in favor of Suboxone. Usually I don’t have a problem. If I do have a patient coming into the clinic specifically asking for Subutex, I become immediately concerned.
The reason for the strict supervision of the methadone clinic is that giving addictive substances to addicts can quickly get out of hand. I think there is reason for concern to prescribe this medication out of the physician’s office and I’m sure the FDA will be watching this closely. During the interim, I think doctors will be slowly reducing the amount of plain buprenorphine they prescribe to avoid the addictive problems that patient may get.
More Oxycontin Drug Dependence Resources:
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