agonist and antagonist opioid replacement drugs.
The purpose of this paper is to explore the pros and cons of Suboxone and Suburex, two treatments for heroin dependence, which are both agonists and antagonists for opioids. The chosen articles, Ling,Walter, et al.’s, “a decade of research by the National Drug Abuse treatment clinical trials network”, Bell, James, et al.’s “a pilot study of bunprenorphine-naxolone combination tablet (Suboxone) in the treatment of opioids dependence” and Mc Cormick’s “management and post-marketing surveillance of CNS drugs”, bring up the benefits and the disadvantages of using Suboxone or Suburex for opioid addictions.
Suboxone is the formulation primarily used in the United States for the treatment of opioids addiction. In addition to burponephrine, it contains Naxolone, an opioid antagonist It is an improvement on Suburex, which contains only burponephrine. The naloxone in Suboxone is well absorbed when one takes the medication as directed sublingually. If however, someone dependent on heroin or other strong opioid analgesics administer Suboxone intravenously, the naloxone will precipitate a very intense withdrawal syndrome. Thus, the addition of naloxone decreases the likelihood of the diversion of Suboxone into the drug-using subculture. The prescription medicine is used to treat adults as part of a complete treatment program also including counseling and behavioral therapy. Additionally, physicians prescribe Suboxone in an office setting thus avoiding the stigma of inpatient treatment and helping the patient maintain a normal life style. Suboxone has become the new replacement drug for opioid users. Reckitt Benckiser Pharmaceuticals UK invented it, the FDA approved it in 2002, and over 7,000 physicians, holding a special license began prescribing it in 2003. Not every health insurance program reimburse Suboxone and the cost can be high, but at $3850 a year, it is still cheaper that
methadone and the treatment is shorter, sometimes the patient will only take Suboxone for 4 to 5 months, including the tapering down part of the process. The drug has been on the market for close to 9 years now so it should become available in a generic form very soon. Buprenorphine is the main active ingredient in Suboxone, in combination with Naxolone. The addition of Naxolone makes the drug very difficult to abuse by a heroin-addicted person in an injected form, as it does not dissolve properly. Before the addition of Naxolone, Suburex, the original Buprenorphine, was frequently abused as an injection drug. The drug seems very efficient to help opioids dependent patients withdraw with only mild symptoms and to stay clean after the treatment. Suboxone at a small dose (2 to 16mg) acts as an agonist, giving the user a similar but much milder experience than heroin, stopping the cravings and the severe symptoms of withdrawal. Taken at a higher dose or more often (24 mg or up), however, it becomes an antagonist, making the patient sick, and unable to take pleasure in using heroin. In 2004, the VA started using Suboxone to treat veterans in their 50s and 60s addicted to prescriptions analgesics like Vicodin and Percocet. Initially the VA used the medicine only for short-term detoxification and was successful, but the long-term recovery rate was substandard. The medicine is now as a long-term maintenance program with much better results. Patients who have used methadone in the past generally reported that Suboxone made them feel much better, energetic, clear headed and functioning almost at their full potential. Additionally, the risk of overdose by buprenorphine is significantly less than that of methadone.
The best results were observed in people who have been successful at quitting the use of heroin before, are regularly employed, and have a relatively stable life with...