Suboxone Posted by:Ken Sutton--Friday, March 16, 2007

I met Melanie Donati ( RN, BSN melanie.donati@reckittbenckiser.com)at an Alliance meeting. Melanie is a Clinical Liaison for Reckitt Benckiser Pharmaceuticals who manufactures Suboxone a treatment for opiate addiction. Attached to this article is a complete patients guide to the drug. There still seems to be a lot of mystery surrounding the use of Suboxone and I have heard all kind of rumors (like it is very expensive compared to Methadone and your insurance won’t cover it - I checked and my insurance covers it for 90 days). I had the chance to ask Melanie a few questions and she was gracious enough to reply and allow me publish them here.

Question: When can you / should you start Suboxone?




Answer: Suboxone therapy can be initiated at any point in recovery. Now that Suboxone awareness is growing it is becoming the first-line treatment of opioid dependence. A patient can certainly be switched from Methadone to Suboxone but they have to be weaned down to about 30 mg of Methadone before the transition can be a smooth one. The biggest factor to this point in deciding when or how to utilize Suboxone has been the number of available providers. Fortunately this number is increasing everyday so the difficulty of finding a provider is becoming much less. Also, many Methadone clinics detox centers, and behavioral health facilities are incorporating Suboxone into their treatment protocols so the availability is much higher now. There is no set rule for when Suboxone is appropriate in opioid dependent patients. It basically boils down to awareness that it is available, finding a provider to initiate treatment, and the patient be willing to try the therapy. It most certainly can be the first course of action. It is indicated for 16 years and older as opposed to Methadone, which is approved for 18 years and older.

Question: I have heard that Suboxone is sold on the street and abused?

Answer: Regarding the street value. This topic comes up a lot and I can tell you that the street value is minimal. With Suboxone there is no high or euphoria as opposed to opioids and Methadone. So, people do not take Suboxone and get high. The street value, which exists, is somewhat unique. If someone is high and they are soon to be in-between fixes and are concerned about becoming “dope sick”, they will buy a Suboxone to prevent that sickness until they find their next drug. Suboxone fills the opioid receptors and prevents withdrawal from occurring until they find their drug of choice. Also, this can be the case whether or not they are trying to get well. If someone is trying to find a treatment provider or a program to accept them the will have to keep taking their drug until that time to prevent withdrawal so Suboxone plays a role until they find their own provider. There is also the person who does not want to get better yet and also does not want to be “dope sick” so they will substitute Suboxone in between fixes. The only way to prevent street sales is for physicians to be very, very cautious on their prescribing habits. If the patients are only getting exactly what they need pills won’t end up on the street. Because the patients need the pills they will not sell what they need themselves. However, if a person received too many pills there is always the possibility for street sales.