Drug addiction and dependence are two separate but often interrelated issues. When someone is addicted to a drug, such as opioids, they have a psychological disease. Drug addiction is characterized by symptoms such as compulsive drug seeking and a loss of control. Continuing to use drugs even when there are negative or harmful consequences is also symptomatic of addiction. Drug dependence is a physical condition. When someone uses opioids, even as prescribed, their body can become dependent. The primary symptom of dependence is going through withdrawal when you stop using the drug.
Opioids can cause both addiction and physical dependence. Whether it’s prescription narcotics or heroin, stopping opioids can be incredibly challenging. Both the psychological and physical elements have to be considered during treatment. Certain medications have been introduced and approved by the FDA to help people struggling with opioid dependence and addiction.
One medication prescribed to help people get through opioid withdrawal is Suboxone. Suboxone is a brand-name medication used as part of a comprehensive drug treatment program. This medicine is a combination of buprenorphine and naloxone. Buprenorphine is a mild opioid that helps prevent withdrawal symptoms and drug cravings while a person goes through detox. Naloxone blocks the effects of opioids, even if someone tries to abuse the Suboxone.
There are benefits to using Suboxone, and it can significantly increase the chances of a successful recovery. At the same time, Suboxone isn’t without risks. There’s increasing concern about the potential for secondary addiction with Suboxone. The risk of addiction is lower than with other opioids, but because of the buprenorphine, it’s not out of the question that someone could develop an addiction to or dependence on Suboxone.
There is also the risk of overdose with Suboxone. In some cases, it could be accidental (e.g., if a child were to come in contact with the Suboxone sublingual film). It’s also possible to overdose if you aren’t opioid-dependent, or if you combine this medication with another central nervous system depressant. Other CNS depressants include other opioids, benzodiazepines (e.g., Xanax) and alcohol.
There are alternative options to Suboxone. There is an entire group of medications referred to as “medication-assisted treatment” or MAT. MAT includes a combination of medicine along with in-depth addiction treatment. For many opioid addicts, MAT has provided the best outcomes.
One of the newest options introduced is called Zubsolv. Like Suboxone, it is a combination of buprenorphine and naloxone. There are some differences between the two, however. First, Zubsolv comes in tablet form, while Suboxone is a film that goes beneath the tongue. There are some preferential differences between Suboxone and Zubslov, such as taste and dosage forms. Zubsolv also has improved bioavailability, which allows the user to absorb the buprenorphine and put it to use more easily. As a result, there is a lower opioid content in a dose of Zubsolv than in a dose of Suboxone. Zubsolv is more affordable under some insurance plans as well. Any physician who is licensed to prescribe Suboxone can prescribe Zubsolv.
A less-used option is methadone. For a long time, methadone and methadone maintenance clinics were the primary way people were treated for opioid dependence and addiction until Suboxone became available. Methadone is an opioid, and it can be prescribed to treat pain as well. Methadone does have the ability to block some of the effects of opioids, but it’s not as effective as Suboxone. The primary problem with methadone maintenance is that it replaces one addiction with another, and people tend to become long-term methadone users.
Subutex is a prescription containing only buprenorphine, so it doesn’t have the opioid-blocking effects of Suboxone. Subutex behaves like an opioid but with milder effects. For example, Subutex doesn’t tend to cause the extreme euphoria of a drug like heroin, particularly when taken at prescribed doses. It also has a lower risk of addiction, and the withdrawal symptoms are less severe than with other opioids. A treatment plan will often start an opioid-dependent individual on Subutex and then move them to Suboxone or Zubsolv.
The only drug on this list that could be considered a true Suboxone substitute is Zubsolv. Zubsolv and Suboxone are very similar, and these are becoming the front-line way to treat opioid dependence and addiction. A Suboxone alternative like methadone or Subutex tends to be falling out of favor because of the risks associated with the use of these substances.
Regardless of whether a Suboxone substitute is being used, or a person is on Suboxone, these drugs are not a cure for addiction. They are not meant to end addiction. Instead, Suboxone or any Suboxone alternative is meant to be one part of a larger plan of treatment that includes therapy, life skills and aftercare. If you’d like to learn more about the treatment options available to you or someone you love, call The Recovery Village. We offer free consultations with our addiction and recovery specialists, no matter where you are in your journey.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.