Subutex vs. Suboxone: An Honest Comparison

Treating opioid addiction poses many challenges. Quitting ‘cold turkey’ is usually not recommended due to continued cravings and potentially dangerous withdrawal symptoms. Certain medications can be used to supplement traditional behavioral therapy and group counseling session to help people in recovery.

Subutex and addiction/prescription-drugs/suboxone-addiction/” title=”Suboxone”>Suboxone are two important prescription medications that are used to treat opioid addiction. While there are some similarities between the two, there are also some important differences to consider.

Subutex and Suboxone Used in Medication-Assisted Treatment

Subutex and Suboxone are brand names of prescription medications used to treat opioid dependence, including addiction to heroin and prescription narcotic painkillers. The main difference between the two is that Subutex contains buprenorphine, while Suboxone contains a combination of buprenorphine and naloxone.

Both medications are used in medication-assisted treatment (MAT) to help people with an opioid use disorder reduce cravings and prevent withdrawal symptoms. According to the National Institute on Drug Abuse, medication-assisted treatment for opioid addiction is used to:¹

• Reduce opioid use
• Reduce opioid overdose deaths
• Reduce the transmission of infectious diseases such as HIV/AIDS
• Reduce the incidence of criminal activities

People following a MAT program are more likely to stay in treatment and are better able to function socially. It is important to understand that a successful medication-assisted treatment program involves both a maintenance treatment medication, like Suboxone or Subutex, and regular behavioral therapy sessions.

Subutex vs. Suboxone

Buprenorphine, which is found in both Subutex and Suboxone was first approved by the Food and Drug Administration for treating opioid dependence in 2002.² Prior to buprenorphine, methadone was the only drug available for treating opioid use disorders. Buprenorphine was different from methadone in that it could be prescribed in a doctor’s office and did not have to be administered from a specialty clinic.

Buprenorphine is a partial opioid agonist and works to treat dependence on opioids by partially stimulating the same receptors as drugs like heroin and prescription narcotics. In this way, buprenorphine prevents onset of withdrawal symptoms and reduces cravings for drugs. It’s these cravings that cause many people to relapse.

Suboxone contains buprenorphine and naloxone, an opioid antagonist. Naloxone blocks the effects of opioid drugs and is used for maintenance treatment of opioid dependence. The two medications found in Suboxone work together to discourage the use of opioids and to prevent relapse. Naloxone—used alone, not in combination with buprenorphine—is also used by first responders and other medical professionals to reverse opioid overdoses.

The Risks of Abuse

Whenever opioid-like medications are used to treat opioid dependence, there is a question of whether or not the medication can or will be misused. Suboxone, because it contains naloxone, is less susceptible to abuse than Subutex. This does not mean that someone using Subutex to overcome addiction will necessarily abuse it, but there is a greater risk.

As mentioned earlier, naloxone is an opioid antagonist that blocks the effects of opioid receptors. In other words, if a person has taken naloxone and then takes an opioid like heroin, the effects of heroin will be blocked. This is why Suboxone carries a lower risk of abuse.

Subutex and Suboxone: Which is Better?

The effectiveness of Subutex and Suboxone in treating opioid dependence is similar. There is one very important consideration when choosing between the two medications. Pregnant women enrolled in a MAT program should use Subutex, as the naloxone present in Suboxone is potentially harmful to their babies.

Medication assisted therapy is best used as part of an addiction treatment program that includes personal therapy and group counseling sessions. The side effects of each maintenance medication are also very similar and most commonly include headache, nausea, vomiting, constipation, insomnia, excessive sweating, constipation, pain and loss of sensation or burning in the mouth with sublingual forms.

The main consideration in choosing between the two is the potential for abuse. Suboxone is more often prescribed, because the addition of naloxone reduces the risk of abusing the medication or other opioids. Subutex does carry some risk of abuse.

Anyone considering MAT must first be assessed by a primary care physician or addiction psychiatrist who is licensed to prescribe medication-assisted treatment medications. Subutex and Suboxone are both effective medications that can be used as part of a comprehensive treatment plan for opioid addiction.