Data were collected for three days during the week of the medication switch and at 1, 2, 3, and 4 weeks following the transfer. The data collection was repeated four months post transfer follow-up period. The data gathered from patient records prior to the switch Subutex dose, drug misuse and frequency of clinic visits is considered as baseline data.
Patient data were collected by the treating physician in each treatment site. Data protection was ensured throughout in accordance with the regulations of the National Public Health Institute. The National Public Health Institute funded the study. The treating physicians at these selected clinics collected data about eligible patients who had undergone a "forced transfer" from Subutex to Suboxone.
Data were collected from patient archives of the respective study sites and stored with codes to protect the personal details of the study patients. Physicians recorded the Subutex dose at the day of the transfer, and the Suboxone doses used during the four weeks following the switch. Data four months after the study period were also collected. Drug misuse measures were recorded as follows: 1 Drug misuse history at the time of entering the clinic; 2 any relevant medical history; 3 signs of buprenorphine misuse before the switch from Subutex to Suboxone and at weeks 1—4 following the switch as evidenced by the presence of fresh needle marks or patients volunteering the information ; 4 signs of misuse of other opioids urine tests and patient reports ; and 5 current misuse of any non-opioid drugs urine tests and patient reports.
Length of non-opioid drug use was also recorded. Adverse events considered being associated with the switch from Subutex to Suboxone on the day of the switch, days 2 and 3, and weeks 1 to 4 following the switch were recorded.
Adverse events four months after the study period were also collected. The MedDRA coding was followed. Overall patient complacence patient satisfaction with the switch to Suboxone: yes, no, why not and compliance, with reasons for non-compliance where available , were recorded on each of the weekly visits to the clinic before and after the switch.
The Finish maintenances treatment legislation on the time of this study states that only good patient compliance allows take-home medication, and at the most for 8 days. Thus, the frequency of weekly visits gives an indirect implication of compliance; the less visits the better compliance.
The 5 treatment centers were located in different parts of Finland. All study doctors were either psychiatrists or general practitioners with long experience in maintenance treatment, and had subspecialty in addiction medicine. Primary outcomes were the dose of buprenorphine before and after switch to Suboxone, and physical signs or patient reports of intravenous misuse of buprenorphine. The records from a total of 64 patients were examined for this study. The mean age and other background demographics are shown in Table 1.
By the end of the 4-week study period, one patient discontinued the maintenance treatment program and three patients were transferred back to Subutex. Out of these three patients, one was transferred back to Subutex due to adverse events and the other 2 patient for a lack of compliance on Suboxone. During the four months follow-up period, the treatment was discontinued with seven The main reasons for change of treatment or discontinuation were IV misuse of buprenorphine 10 patients , misuse of other drugs 8 patients , adverse events 6 patients and dissatisfaction with Suboxone 5 patients.
Fifty-eight patients One patient was transferred with a higher Suboxone dose 2 mg , two with lower doses 2—4 mg and three patients were "titrated" with daily increases of Suboxone patient anxiety over the transfer up to the previous Subutex dose Table 2.
Out of the 60 patients finishing the 4-week study period, 53 patients During the 4 week period, 4 patients 6. Two patients 3. Out of the 26 patients continuing treatment with Suboxone, 10 patients At baseline, 9 patients Forty-seven patients Information on IV misuse of buprenorphine was not recorded for 8 patients Twenty patients At weeks one, two and three, seven, three and six patients, respectively, showed signs of IV abuse of buprenorphine Subutex or Suboxone.
Three patients who had records of IV-misuse at baseline did not continue misusing during the 4-week follow up period, and three new patients with IV-misuse were observed during this period. Over the 4-week study period, there was no evidence of misuse of other opioids. Regulators, law enforcement officials and treatment professionals agreed that Suboxone can help some addicts kick drugs — which is why they don't want to cut off access for legitimate patients.
We want as many people as possible to get help, but we don't want the abuse," Ingram said. The goal is to gradually reduce the dosage over time until a patient tapers off the medication, and some take it for years.
But much of the research into its effectiveness looks at short-term use. A study in the Journal of the American Medical Association showed that addicted youths who took Suboxone for 12 weeks were less likely to use opioids, cocaine or marijuana, or to drop out of treatment, than those who received only short-term detox and counseling. But Ingram said there's a fierce debate between experts favoring medication-assisted treatment and favoring residential treatments that don't use medicine.
A report showed only 8 percent of people treated at Kentucky recovery centers, which offer a long-term residential program without medication therapy, were using illegal drugs at a six-month follow-up. Plus, he and others argued, there is simply not enough residential treatment for the growing number of addicts. Conway said Kentucky has just a tenth of the treatment beds it needs, and a Courier-Journal analysis found that less than 15 percent of treatment and recovery sites offer hour residential care; most are for outpatients only.
Although Hascal works in a recovery center that doesn't use Suboxone, she said the medicine may work for some people and should be part of the arsenal for treating the persistent scourge of addiction. It's touted as the solution for addiction, but it's not. Facebook Twitter Email. Addiction medicine Suboxone now being abused.
Show Caption. Hide Caption. Recovered Suboxone addicts talk about their experience with the drug. Jessica Ebelhar, The Courier-Journal. Legislators announce bill to combat heroin. Katie Stine, R-Southgate, and Rep. Suboxone and methadone have been compared in clinical studies evaluating their use for treating opioid dependence.
In a study , Suboxone and methadone were found to be equally effective for reducing the use of opioids and keeping users in their treatment program. A study found that people taking Suboxone used opioids less compared to people taking methadone. However, the people taking methadone were more likely to stay in their treatment program.
An analysis of several studies found that overall, Suboxone was more effective for reducing the use of opioid drugs, but methadone was more effective for keeping users in their treatment program.
Suboxone and methadone have some similar side effects, and some that differ. Below are examples of these side effects. This is the strongest warning that the FDA requires. A boxed warning alerts doctors and patients about drug effects that may be dangerous. Methadone usually costs less than brand-name or generic Suboxone. Both Suboxone and Zubsolv are brand-name medications that contain two drugs: buprenorphine and naloxone.
Both Suboxone and Zubsolv are FDA-approved to treat opioid dependence, including the induction and maintenance phases of treatment. Suboxone and Zubsolv contain the same drugs and are used in the same way to treat opioid dependence. The decision to use Suboxone or Zubsolv is based on personal preference for use of the sublingual film or tablet. Suboxone and Zubsolv are brand-name drugs. Zubsolv usually costs less than brand-name or generic Suboxone.
Buprenorphine is classified as an opioid partial agonist-antagonist. This means it has some effects like opioid drugs, but it also blocks other opioid effects. Vivitrol is a brand-name medication that contains the drug naltrexone.
Naltrexone is an opioid antagonist, similar to the naloxone contained in Suboxone. This includes two phases of treatment: induction and maintenance.
Vivitrol is also approved to treat opioid dependence. Suboxone and Vivitrol have been compared in clinical studies. A study found that Vivitrol and Suboxone were equally effective for reducing opioid and heroin use over 12 weeks. A study found that Suboxone was more effective for preventing relapse and was easier to use than Vivitrol.
Suboxone and Vivitrol have some similar side effects, and some that differ. Suboxone and Vivitrol are brand-name drugs.
Generic versions often cost less than brand-name drugs. Vivitrol usually costs much more than brand-name or generic Suboxone. The actual amount you pay will depend on your insurance. Both Suboxone and Bunavail are brand-name medications that contains two drugs: buprenorphine and naloxone. This includes both the induction phase and the maintenance phases of treatment. Suboxone is available as an oral film that can be used under your tongue sublingual or between your gums and your cheek buccal.
Suboxone and Bunavail contain the same drugs and are used in the same way to treat opioid dependence. The decision to use Suboxone or Bunavail is based on personal preferences for use of one product or the other.
Suboxone and Bunavail are brand-name drugs. Bunavail usually costs less than brand-name or generic Suboxone. Naltrexone is a generic medication. Naltrexone is classified as an opioid antagonist, similar to the naloxone contained in Suboxone. Naltrexone is also approved to treat opioid dependence. A clinical study found that Suboxone was more effective for reducing opioid use than naltrexone over 12 weeks. Suboxone and naltrexone have some similar side effects, and some that differ.
Naltrexone oral tablet is a generic drug. However, naltrexone also comes as extended-release injection. This form is only available as the brand-name drug Vivitrol [see above]. Naltrexone usually costs less than brand-name or generic Suboxone. Suboxone can interact with several other medications. It can also interact with certain supplements as well as certain foods. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.
Below is a list of medications that can interact with Suboxone. This list does not contain all drugs that may interact with Suboxone. Before taking Suboxone, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take.
Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Taking Suboxone with benzodiazepines can increase the risk of severe side effects such as severe sedation sleepiness , breathing problems, coma, and death.
Taking these drugs with Suboxone can increase the risk of side effects. Certain medications make an enzyme called cytochrome P 3A4 CYP3A4 more active and can increase how fast the body breaks down Suboxone. This can make Suboxone less effective.
Taking Suboxone with medications that increase serotonin levels in your body might increase your risk of developing serotonin syndrome, a drug reaction that can be dangerous. Anticholinergic drugs block the action of a chemical messenger called acetylcholine. Taking these drugs with Suboxone might increase the risk of side effects such as constipation and urinary retention.
Xanax alprazolam is classified as a benzodiazepine. Taking Suboxone with benzodiazepines, including Xanax, can increase the risk of severe side effects. These include severe sedation sleepiness , breathing problems, coma, and death.
Taking tramadol Ultram, Conzip with Suboxone can increase the risk of side effects such as serotonin syndrome and decreased breathing. Suboxone may also make tramadol less effective for treating pain. There are no known interactions between Adderall amphetamine and dexamphetamine salts and Suboxone.
Klonopin clonazepam is classified as a benzodiazepine. Taking Suboxone with benzodiazepines, including Klonopin, can increase the risk of severe side effects. Suboxone and anesthesia used for surgery may interact and increase your risk of serious side effects. Before having surgery, talk with your doctor about your treatment with Suboxone. You may need to temporarily stop taking Suboxone. Taking Suboxone with Ambien zolpidem can increase the risk of severe side effects. Taking codeine with Suboxone can increase the risk of side effects such as decreased breathing.
Suboxone may also make codeine less effective for treating pain. Supplements that affect serotonin levels can increase your risk of developing serotonin syndrome. Some herbs and supplements can cause sleepiness. Taking these along with Suboxone might increase your risk of excessive sleepiness. Examples of these supplements include:. Because of this, taking St.
Drinking grapefruit juice while taking Suboxone might increase levels of Suboxone and increase your risk of side effects. Suboxone is not swallowed. Instead, the film is placed under your tongue or between your gums and your cheek, where it will dissolve. Findings from this study highlight the importance of peer networks for the dissemination of harm-reduction information.
Introduction of new formulations internationally requires more qualitative studies to inform safer practices. Keywords: buprenorphine-naloxone; harm reduction; intravenous drug abuse; patient non-adherence; qualitative research.
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