Opioids are a specific class of drugs that includes prescription narcotics like Vicodin as well as non-prescription drugs like heroin. Opioids, even when taken by prescription, have a high likelihood of leading to addiction and physical dependence. Addiction and dependence are two distinct concepts. Addiction refers to a psychological disease. Addiction symptoms include compulsive drug use, continued drug use even when there are negative consequences, and feeling like drug use is out of control. Dependence is a physical issue where a person’s body goes into a type of shock if they suddenly stop using a drug after a period of time. The primary symptom of opioid dependence is withdrawal.
Opioid withdrawal can range from mild to severe discomfort, depending on factors like the length of drug use. Withdrawal symptoms may include muscle aches and cramps, anxiety, cold-like symptoms, nausea and vomiting. Withdrawal is one of the primary obstacles for people who want to stop using opioids. Certain medications can help reduce or alleviate symptoms of withdrawal, and they can be used when combined with a drug treatment program. Two options are Subutex and Suboxone, which share similarities with one another as well as some differences.
Subutex is a brand-name drug available by prescription to help with opioid dependence and withdrawal. It is administered as a sublingual tablet. The active ingredient in Subutex is buprenorphine, which is classified as an opioid agonist-antagonist combination. This means that when used, buprenorphine acts in many of the same ways as prescription opioids or heroin but with some differences. Buprenorphine causes less euphoria and milder withdrawal symptoms, and there is a ceiling on its effects. Beyond that ceiling, even if someone continues using buprenorphine, the effects won’t be amplified.
Before taking Subutex, a person should have stopped using opioids since the drug binds to the same receptors as opioid drugs to stop withdrawal symptoms. Subutex can also reduce drug cravings. The best way for Subutex to be given is either four hours after the last dose of an opioid or after opioid withdrawal symptoms have started. If Subutex is taken too soon after the last dose of opioids it can cause withdrawal symptoms.
Many of the side effects of Subutex are similar to opioids. For example, people on Subutex may experience constipation and require a laxative to help with this. Other side effects can include feeling dizzy or lightheaded. Subutex also has the potential for abuse, addiction, and dependence although this risk is lower than in other opioids. Subutex should be used only as instructed, under careful medical supervision and as part of an in-depth treatment plan to avoid the abuse risk. Some people may crush and snort or inject Subutex to feel high from it. Another way to abuse it is to combine it with other central nervous system depressants such as benzodiazepines. This is risky not only from an addiction standpoint but also because it can cause fatal respiratory depression.
Subutex isn’t without possible risks, but when it’s used as part of a full drug treatment program it also has benefits. A medical care provider will usually weigh the potential risks and benefits before giving Subutex to a patient. As long as a patient follows instructions carefully, the risks are pretty low with Subutex, especially as compared to heroin and prescription narcotics.
There is another drug that is similar to Subutex with the active ingredient buprenorphine, and that’s Suboxone. Suboxone is available as a sublingual film, and along with delivery buprenorphine, Suboxone also contains naloxone. Suboxone was created in response to the risks of buprenorphine abuse. The naloxone component of this medication helps prevent abuse. Naloxone blocks the effects of opioids if Suboxone is injected. When someone takes Subutex sublingually, they don’t feel the effects of naloxone. This is only felt if someone tries to inject the drug or snort it. The naloxone completely blocks any euphoria or pleasant feelings of the buprenorphine in the drug.
Despite the naloxone, there is still a low risk of respiratory depression with Suboxone. This is especially true if it is combined with other central nervous system depressants. Benzodiazepines like Xanax depress the CNS, as does alcohol. Taking stimulants with Suboxone can also be dangerous because the drugs mask the effects of one another and increase the likelihood of an overdose.
So, what is the difference between Suboxone and Subutex? Both are brand-name prescription drugs used to treat opioid dependence. Both can prevent withdrawal symptoms to increase the chances of successful addiction treatment. Both Suboxone and Subutex also have the active ingredient buprenorphine, which is a partial opioid agonist. The key difference between Suboxone and Subutex is that Suboxone has naloxone. Naloxone helps prevent abuse of Suboxone by blocking opioid effects if someone tries to inject or snort it to get high. During some treatment programs patients may first be prescribed Subutex and then move onto Suboxone.
Medications like Suboxone and Subutex can be helpful during the recovery process, and research shows they do improve the chances for success. That said, they aren’t entirely risk-free. These medications are designed to be used under the instructions and supervision of a physician experienced in addiction medicine and recovery.
Do you have a problem with prescription drugs? Do you see the weight of addiction destroying the life of a loved one? The Recovery Village is available and ready to answer questions related to addiction, treatment and starting a program as soon as possible.
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.