Suboxone to Subutex

Anything about buprenorphine that doesn't fit somewhere above, fit it here!
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dmartinez76
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Suboxone to Subutex

Post by dmartinez76 »

I have been having a hard time coming off of Suboxone, my doctor prescribed me Subutex films to try and ween me off, has anyone or their doctor tried this method?
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suboxdoc
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Re: Suboxone to Subutex

Post by suboxdoc »

You must not be in the US? There is no Subutex film in the USA. We used to have Subutex tabs, but they were taken off the market at the same time that Suboxone film came out.

There is no difference for patients between Suboxone and plain buprenorphine, what we used to call 'Subutex'. None. I often have people here or wherever insist they are different, but I point out the studies that got Suboxone approved, and the basic pharmacology of naloxone. Naloxone is not absorbed to any significant level through mucous membranes. Studies suggest that about 3% of the 2 mg in a standard dose becomes absorbed -- an amount of no significance compared to the amount of buprenorphine. And naloxone has a very short half-life, so that any that IS absorbed is gone within 20 minutes. How could it do anything?

Naloxone was added to buprenorphine for ONE reason -- to reduce injecting. That's it. Pharmacists think 'you need the naloxone so it won't make you high'. Idiots. Truly. Getting 'high' is a function of 1. the person's opioid tolerance, and 2. whether other opioids are on board, causing precipitated withdrawal. Naloxone, BTW, has NOTHING to do with precipitated withdrawal. NOTHING. It is all from buprenorphine, displacing opioid agonists from the mu receptor. Period.

I cannot imagine a reason one would be better for a taper than the other. They are, after all, the same! Maybe (here is a stretch) he is thinking of studies that show that 'very low dose NALTREXONE' reduces withdrawal symptoms in patients tapering off methadone... a real study. But the study only looked at symptoms for one week -- which makes the results hard to interpret. Also, that was NALTREXONE -- an orally - active, long-half-life opioid antagonist. Yes, it sounds sort of like naloxone, but they are entirely different medications. One lasts for 20 minutes, the other for 20 hours. One enter the body and the other doesn't. If that's the case, he is thinking... but I don't think his idea will work.
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