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PostPosted: Wed Sep 16, 2015 9:52 pm 
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I am about to switch from methadone to suboxone. My insurance will not pay for Suboxone film, only generic suboxone. Just wondering which generic is best to ask the doctor for. I have read good and bad reviews on Zubsolv and the Activis pills. Anybody that has experience with any of the generics, I would like to hear about it.


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PostPosted: Wed Sep 16, 2015 10:52 pm 
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People sometimes get confused between generic buprenorphine vs. generic buprenorphine/naloxone. To clarify, there are three classes of meds:
1. Brand products: Suboxone film, Zubsolv, and Bunavail.
2. 'Generic Suboxone'-- which is a misnomer, since 'Suboxone' is a brand name. This category consists of several generic formulations of buprenorphine and naloxone, in an 8/2 ratio.
3. 'Generic Subutex' or 'Subutex'-- again a misnomer, since Subutex was taken of the market 5 years ago. This category consists of plain buprenorphine, without naloxone, made by 4 or 5 generic manufacturers including Arrow, Teva, and others.

Category one products retail for around 8 bucks per dose. Category 2 for a buck or two less. Category 3 is cheap, but some states have blocked use of plain buprenorphine, mistakenly thinking it is 'just like heroin'. I've even heard some doctors share that opinion-- which tells me that there is a LOT of ignorance about basic neurochemistry, even in physicians. Buprenorphine has the same effects as the other categories; the naloxone has only one function, and that is to prevent IV use (since it is not active sublingually or orally). But it is hard to imagine a benefit to IV buprenorphine beyond blocking withdrawal. If a person has used heroin or oxycodone within a few hours, buprenorphine will cause withdrawal. If a person has a high opioid tolerance, buprenorphine (including IV) will do nothing. The only value of IV buprenorphine is for a person with no or low tolerance to opioids, where IV buprenorphine would have a significant opioid effect... but then that person would have a blockade in place against using opioid agonists for the next few days.

In other words, an addict who injects buprenorphine is essentially 'treated with buprenorphine' for a few days. Heroin will not cause a high, and neither will oxycodone.

Yet insurers refuse to pay for buprenorphine, and medicaid refuses to allow patients to use buprenorphine. Insurers and some medicaid agencies cut off treatment after two years.... when they could cover 8 years of buprenorphine for the same price.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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