How Is Suboxone Treatment Different than Drug Abuse?

Physicians who treat opioid addiction also have the option of utilizing ‘medication-assisted treatment,’ and the most common medications used in the treatment of opioid dependence today are methadone, naltrexone, and buprenorphine (Suboxone).
Most people cannot just walk away from opioid addiction. They need help to change their thinking, behavior, and environment. Unfortunately, “quitting cold turkey” has a poor success rate – fewer than 25 percent of patients are able to remain abstinent for a full year. This is where medication-assisted treatment options like methadone, naltrexone, and Suboxone benefit patients in staying sober while reducing the side effects of withdrawal and curbing cravings which can lead to relapse.
Methadone is an opioid and …

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A Prospective, Randomized, Multicenter Acceptability And Safety Study Of Direct Buprenorphine/Naloxone Induction In Heroin�Dependent Individuals

Conclusions:  Direct BNX induction was a safe and effective strategy for maintenance treatment of opioid dependence. Response to high�dose direct BNX induction appears to be similar to indirect BPN�to�BNX induction and was not associated with reports of intravenous BNX misuse. (Source: Addiction)

Transfer from high dose methadone to buprenorphine/naloxone.

Authors: Wallace M
PMID: 21853690 [PubMed – in process] (Source: Australian Nursing Journal)

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Differential Pharmacological Actions of Methadone and Buprenorphine in Human Embryonic Kidney 293 Cells Coexpressing Human μ-Opioid and Opioid Receptor-Like 1 Receptors.

In this study, we compared their effects on adenylate cyclase (AC) activity in human embryonic kidney (HEK) 293 cells stably overexpressing human μ-opioid receptor (MOR) and nociceptin/opioid receptor-like 1 receptor (ORL1) simultaneously. After acute exposure, methadone inhibited AC activity; however, buprenorphine induced compromised AC inhibition. When naloxone was introduced after 30 min incubation with methadone, the AC activity was enhanced. This was not observed in the case of buprenorphine. Enhancement of the AC activity was more significant when the incubation lasted for 4 h, and prolonged exposure to buprenorphine elevated the AC activity as well. The removal of methadone and buprenorphine by washing also obtained similar AC superactivation as that revealed by naloxone challen…

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AbstractNAATP: Goodbye to Last Year, Hello to Health Reform, New CEOTASC Stays Focused on Reform Despite Illinois Budget ChallengesChildhood ADHD Found to Predict SUDs 10 Years LaterFDA Says Okay to Give Vivitrol or Suboxone Without CounselingCalifornia Set to Eliminate ADP; Counties Would Administer FundsBriefly NotedResourcesComing up (Source: Alcoholism and Drug Abuse Weekly)

NY Times on Suboxone Abuse in Prison

The NY Times this morning had an interesting article on a problem of which I was completely unaware: the abuse of Suboxone in prisons. According to the report:
“Innovative smugglers have turned crushed Suboxone pills into a paste and spread it under stamps or over children’s artwork, including pages from a princess coloring book found in a New Jersey jail.”
Suboxone (buprenorphine and naloxone combined in a 4:1 ratio) have recently become available as orange strips — similar to breath strips — that dissolve under the tongue.  Buprenorphine, a mixed opioid agonist-antagonist, has similar effect to those of morphine or heroin but is less potent and longer-lasting.  It has long been used in Europe as an alternative to methadone for drug detox.  The idea of com…

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AbstractColumn Promoting Suboxone Film, Criticizing Methadone, Angers FieldCenter Takes Proactive Approach on Integrated Care, Research EffortsStates Encouraging Providers to Enroll in MedicaidLegal Action to Enforce Parity Contemplated, Ramstad Tells ADAWJournalist in Recovery Describes Her Experience in MATBriefly NotedIn the StatesBusinessResourcesComing up (Source: Alcoholism and Drug Abuse Weekly)