Buprenorphine is a life-saving medication that helps people beat opioid addiction by easing withdrawal and reducing cravings.
Buprenorphine is an opioid itself, but unlike other opioids, such as heroin and oxycodone, it only partially stimulates the brain’s opioid receptor. This partial binding leads to what is known as a “ceiling effect” for opioid effects such as euphoria and respiratory depression. The ceiling effect makes buprenorphine safer in two key ways: it results in a lower risk of addiction than other opioids, and also results in lower risk of respiratory problems.
We break down 5 popular brands of buprenorphine and what makes them different:
Suboxone is the most popular brand, so popular in fact that Suboxone and buprenorphine are used interchangeably. Suboxone comes as a film that you put under your tongue to dissolve and also contains naloxone, an opioid antagonist best known for its ability to save lives in the event of an overdose. When taken under the tongue, the naloxone in Suboxone doesn’t do anything, but should one dissolve and inject the film they will experience sudden withdrawal.
Zubsolv is another brand of buprenorphine and comes in tablets that you dissolve under your tongue. Like Suboxone, Zubsolv contains naloxone to deter misuse. Besides the name and being a tablet as opposed to a film, there is not much difference between Subxone and Zubsolv. Each brand has a different taste, and some people prefer one to the other.
A generic for Suboxone has been approved by the FDA and can be ordered at the pharmacy as buprenorphine/naloxone (no fancy names). Again, as with all medications, some people prefer name brands to generics but there is no difference in the actual medication.
Subutex is buprenorphine without the naloxone and comes as tablets to be dissolved under the tongue. While Suboxone is preferred due to its lower risk of misuse, Subutex is often used during pregnancy.
Sublocade is a new once-a-month injection of buprenorphine, which is quite different than the other medications described. Patients have to be started on Suboxone, Zubsolv or Subutex before taking Sublocade, then be transitioned to Sublocade. A big advantage of Sublocade? You don’t have to worry about taking films or tablets daily. A drawback to Sublocade is finding a prescriber, and the buprenorphine persisting in the body for 28-30 days after the last injection complicating attempts to come off of buprenorphine when you are ready.
All these forms of buprenorphine can only be prescribed by physicians, nurse practitioners and physician’s assistants who obtain a special waiver from the federal government. You can find waivered providers at Suboxone.com. We at Workit Health prescribe Suboxone and Zubsolv at our Lafayette, CA and Ann Arbor, MI clinics and use our telemedicine platform to provide medication-assisted treatment online.
Regardless of what brand of buprenorphine you and your healthcare provider choose, you should know that buprenorphine is the evidence-backed treatment for opioid addiction.
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Ali Safawi is a humble intern with big dreams of connecting communities and institutions to tackle addiction.