Buprenorphine vs Suboxone: Understanding the Distinction

Opioid use disorder (OUD) is a major public health concern in the United States that is quickly approaching epidemic proportions. Studies show the prevalence of OUD nearly doubled between 2002 and 2018. On top of that, in one month in 2015, around 4 million people reported misusing prescription pain medication. Even more concerningly, the number of deaths due to drug overdose has tripled over the past decade.

Luckily, medication-assisted treatments (MAT) are a safe and effective option to combat OUD. Examples of medications used for this purpose include buprenorphine, methadone, and Suboxone. Studies show MAT can increase user compliance, lower the risk of relapse and reduce the incidence of suicide. At the same time, it also decreases the chances of opioid overdose-related deaths.While many medications for OUD exist, they are not equal. This article compares the two of the most popular options: Suboxone and buprenorphine. Read on to learn more.

Why Are Buprenorphine Containing Treatments Preferred?

Health care providers prefer buprenorphine-based treatments to other medications for three main reasons.

Lower Risk of Overdose

In a study of over 16,000 people, researchers found the risk of overdose death to be four times lower with buprenorphine compared to methadone.

Easy Accessibility

According to the 2018 SUPPORT act, qualified practitioners can prescribe buprenorphine in private offices. But, medications such as methadone are only available in single doses from federally regulated facilities.

Fewer Drug Interactions

A review of medications shows buprenorphine has fewer drug interactions than other OUD medications. This is important because users receiving MAT are often on other treatments such as antiretroviral therapy for HIV.

Is Buprenorphine the Same as Suboxone?

Buprenorphine and Suboxone aren't the same. Buprenorphine is a partial opioid agonist FDA-approved for use in OUD and pain management. Suboxone is a brand-name medication containing two active ingredients, buprenorphine, and naloxone. It is only FDA-approved for OUD.  

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What is Buprenorphine?

Buprenorphine is a partial agonist of mu-opioid receptors. In other words, buprenorphine reduces cravings and prevents withdrawal symptoms by occupying opioid receptors. At the same time, it is safer than other opioids, given its partial activity.

What Forms is Buprenorphine Available in?

Buprenorphine is available in the following forms:

• Sublingual dissolvable strips
• Oral tablets
• Slow-release implants
• Liquid injections
• Skin patches

Here is a list of brand-name preparations available in the United States and Canada that contain buprenorphine:

Buprenorphine Benefits:

Proven Treatment for OUD

Studies show buprenorphine is a safe and effective medication for OUD. In a meta-analysis of 3 trials including 700 patients, researchers found buprenorphine significantly reduced the misuse of opioids. Similarly, a Swedish study found buprenorphine to be up to 75% effective in preventing the ongoing misuse use of opioids.

Buprenorphine users also report tangible improvements in their socio-economic outlook. For instance, participants of one study reported:

• 75% reduction in heroin use
• 97% reduction in money spent on illicit drugs
• Lesser involvement in criminal activities
• An increase in total income and an improved ability to hold down a job

Safer Risk Profile

Buprenorphine is one of the few medications with a ceiling effect. This means its effects level off at lower doses than other opioids. In other words, it has a lower risk for abuse and overdose.

Buprenorphine Side Effects

Buprenorphine, like any other medication, is not free from side effects. Luckily though, its adverse effects are rare and generally mild. Here is a list:

Dental Problems

Dental issues such as abscesses and dental cavities are important but rare side effects of using oral dissolvable forms of buprenorphine.

Luckily, these are easily preventable by thoroughly rinsing your teeth and gums after medication use. In addition, it's best to wait at least an hour before brushing your teeth. This helps protect the enamel coating of your teeth.

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What is Suboxone?

In 2002, the FDA approved Suboxone, a combination of buprenorphine and naloxone, for treating opioid use disorder. Unlike buprenorphine, it is not yet licensed for use as a pain-killer.

Suboxone is a brand-name medication that contains four parts buprenorphine to one part naloxone in varying strengths. It is available as a sublingual strip.

The Role of Naloxone in Suboxone

Manufacturers add naloxone to Suboxone to lower the risk of buprenorphine misuse. This is because, while buprenorphine is safer than other opioids, users can still misuse it by injecting it.

Naloxone is an opioid antagonist with poor oral bioavailability. This means the body does not absorb it when taken orally. Thus, naloxone is only active when users inject Suboxone into the bloodstream. In other words, when patients inject Suboxone, naloxone binds to opioid receptors precipitating withdrawal symptoms to deter users.

Can You Take Suboxone and Buprenorphine Together?

No. Taking Suboxone and buprenorphine together increases the risk of OUD overdose and death. 

Should I Take Buprenorphine or Suboxone?

Currently, there's no scientific evidence to suggest one is more effective than the other for OUD. But, the American Society of Addiction Medicine recommends Suboxone for both withdrawal management and treatment of OUD, given the lower risk of medication misuse. 

Regardless of which medication you use, combining it with therapy and counseling can fast-track your recovery.

Confidant Health Is Your One-Stop OUD Solution.

With its suite of virtual services, Confidant Health provides everything you need at the click of a button. So look no further if you need help with OUD. Visit Confidant Health and consult with one of our online medical providers today.

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