Subutex vs Suboxone
Subutex and Suboxone are both buprenorphine medications used to treat opioid use disorder. Which one is right for you?
Suboxone FAQs
Suboxone is a brand name for an FDA-approved medication (buprenorphine/naloxone) used to treat opioid addiction. Other brand names include Zubsolv and Bunavail, and generic options are also available. Buprenorphine/naloxone is endorsed by the Substance Abuse and Mental Health Service Administration as an effective method of treatment for opioid addiction treatment.
Subutex FAQs
Subutex is a brand name for a medication that contains only buprenorphine as an active ingredient. Like Suboxone, Subutex is an FDA-approved medication that helps to treat opioid addiction.
How does Suboxone work?
Suboxone (buprenorphine/naloxone) is a medication used to sustain recovery from opioid use disorder. It is called a partial opioid agonist, meaning it works in a similar way to opioids by binding to opioid receptors in the brain which causes limited pleasurable effects to stop withdrawal symptoms. However, it won’t provide the “high” associated with opioids like heroin. Suboxone also contains naloxone (known by the brand name Narcan), which is an opioid antagonist meaning it blocks opioid receptors, preventing misuse.
Bottom line, Suboxone (buprenorphine/naloxone):
- Helps alleviate withdrawal symptoms
- Reduces cravings for opioids
- Prevents misuse of Suboxone and/or other opioids
- Decreases the risk of relapse
Like other medication-assisted treatments, Suboxone (buprenorphine/naloxone) is often prescribed as part of a treatment program that includes behavioral health support. You can read more about the science of Suboxone (buprenorphine/naloxone) in our blog.
How does Subutex work?
Subutex is a brand name for buprenorphine, which is a partial opioid agonist, meaning it works in a similar way to opioids by binding to opioid receptors in the brain which causes limited pleasurable effects to stop withdrawal symptoms. However, it won’t provide the “high” associated with opioids like heroin.
Bottom line, Subutex (buprenorphine):
- Helps alleviate withdrawal symptoms
- Reduces cravings for opioids
- Decreases the risk of relapse
Like other medication-assisted treatments, Subutex (buprenorphine) is often prescribed as part of a treatment program that includes behavioral health support.
Do I have to stop taking opioids to take Suboxone?
Yes. According to the American Society of Addiction Medicine, you will need to prepare for your first dose of medication-assisted treatment containing buprenorphine. This means stopping using opioids for a specified amount of time before you take Suboxone (buprenorphine/naloxone) in order to prevent unpleasant side effects. That time period depends on whether the opioid you have been taking is a short-acting or long-acting opioid. Generally speaking, short-acting opioids like Percocet, heroin, and Vicodin should be ceased 12-24 hours before your first dose. Longer-acting opioids, like morphine, methadone, and Oxycontin are generally discontinued 36-48 hours before your first dose of Suboxone (buprenorphine/naloxone).
The key is checking in with an experienced physician licensed to prescribe this medication, who can advise you of the appropriate time frame based on your unique medical history.
Do I have to stop taking opioids to take Subutex?
Yes. According to the American Society of Addiction Medicine, you will need to prepare for your first dose of medication-assisted treatment containing buprenorphine. This means stopping using opioids for a specified amount of time before you take Subutex (buprenorphine) in order to prevent unpleasant side effects. That time period depends on whether the opioid you have been taking is a short-acting or long-acting opioid. Generally speaking, short-acting opioids like Percocet, heroin, and Vicodin should be ceased 12-24 hours before your first dose. Longer-acting opioids, like morphine, methadone, and Oxycontin are generally discontinued 36-48 hours before your first dose of Subutex (buprenorphine).
What are the side effects of Suboxone?
Like with any medication, some people experience side effects when taking Suboxone (buprenorphine/naloxone). These may subside over time. Common side effects include:
- numbness or pain in the mouth
- dental problems
- mouth redness
- dizziness
- headache
- numbness or tingling
- sleep problems
- stomach pain
- vomiting
- constipation
- drowsiness
- difficulty concentrating
What are the side effects of Subutex?
Some of the reported side effects of taking Subutex (buprenorphine) include:
- sleep problems
- headache
- constipation
- nausea
- vomiting
- sweating
- pain
- dental problems
- numbness or tingling
- dizziness
- drowsiness
- difficulty concentrating
As with many medication side effects, they vary per person and may dissipate after a period of time, as the body adjusts to the medication.
What form does Suboxone come in?
Suboxone is a sublingual film—a thin, flat rectangle designed to be dissolved under the tongue. Other brands of buprenorphine/naloxone come in the form of sublingual films and tablets. It is important to allow the medication to fully dissolve under the tongue or against the cheek (not chewing or swallowing) in order to receive the full dosage, as buprenorphine is not absorbed well in the stomach or intestines.
How form does Subutex come in?
Subutex is a sublingual pill. It is important to allow the medication to fully dissolve under the tongue or against the cheek (not chewing or swallowing) in order to receive the full dosage, as buprenorphine is not absorbed well in the stomach or intestines.
Why is there naloxone in Suboxone?
You may have heard of naloxone under the brand name Narcan. Narcan and other naloxone-only formulations are life-saving medications that can reverse an opioid overdose almost instantly. This means that if someone has too much of an opiate in their system, naloxone will bind more strongly to those receptors, knocking them free and reversing a potentially fatal overdose.
As mentioned above, Suboxone (buprenorphine/naloxone) is taken sublingually (placed under the tongue and allowed to dissolve). This is because buprenorphine is absorbed really well under the tongue. Naloxone, however, does not absorb well sublingually. When you take Suboxone as prescribed, the naloxone is essentially doing nothing. It is only is Suboxone (buprenorphine/naloxone) is taken inappropriately that naloxone will kick in, blocking an illicit high or overdose. This is included to make Suboxone (buprenorphine/naloxone) less likely to be diverted or misused.
Does it matter that there is no naloxone in Subutex?
With any opioid medication, there is always great concern about diversion. There are a lot of regulations to try to ensure that no one is sharing, selling, or misusing their medication. That concern is the reason naloxone is included in Suboxone. When taken as directed, the naloxone in Suboxone is inert (it doesn’t do anything). It is, however, active when the medication is snorted or injected, blocking any euphoric effects of the buprenorphine.
Since Subutex has no naloxone, it doesn’t have that safeguard. Many providers are hesitant to prescribe it without increased oversight or a strong, medical reason (like a documented allergy to naloxone). Since telehealth has, by necessity, less oversight than many in-person treatment options, it is common for telehealth providers, especially, to decline to prescribe Subutex.
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