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What are the differences between Methadone vs. Suboxone?

According to the National Institute on Drug Abuse, 3.7 million Americans have used heroin at least once in their lives and there are anywhere between 121,000-164,00 new users each year. Heroin is classified as an opioid and is made from morphine, a substance found naturally in poppy seeds. The drug is very addictive and has the fastest onset of action when injected. Individuals and society pay a steep price for addiction, in the form of destroyed personal and professional lives, higher crime rates, hepatitis and HIV transmission and even death.

So, how does heroin work? Heroin works by triggering certain "receptors" in our brains and bodies leading to the release of chemicals that make us feel euphoric and reduce pain. Think of this mechanism like a lock and key. Heroin is the key that opens the lock, i.e. the receptors.

These same receptors, the opioid receptors, cause other physical changes including sedation, reduced respiration, miosis (constricted pupils) and constipation. Under some circumstances, such as overdosage or mixing heroin with alcohol, respirations can become so depressed that the user actually experiences respiratory arest, which can be fatal.

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When a heroin user looks for help, there are a number of treatment options. The most widely recognized treatment option is Methadone maintenance treatment. For over 30 years, clinics have been dispensing methadone to heroin addicts to try to wean them from their addiction. Methadone is a longer and more gradually acting opioid that helps to reduce withdrawal symptoms (restlessness, pain, insomnia, diarrhea, vomiting, cold flashes, kicking movements) and craving that drive so many users back to heroin.

Though methadone is supposed to be a bridge to recovery from addiction, many users lapse back to heroin use without methadone. Accordingly, users often remain on methadone for years, sometimes even indefinitely.

Methadone Concerns

Methadone treatment is not without risks and drawbacks. Though considered less addictive, methadone is still an addictive drug. Patients who overdose on methadone can also suffer the same fatal respiratory depression as on heroin.

Additionally, not all states permit methadone treatment and many recovering addicts are forced to drive hundreds of miles to receive help. Even when they do get help, laws in many states require that people continue to receive supervised treatment for up to 5 years before they're eligible to take methadone without supervision at home. Many people report feeling stigmatized by the intrusiveness and inconvenience of forced clinic visits.

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Suboxone Advantages

When a user considers or experiences all the cons to methadone treatment, they may be directed down another path. In 2002, a different opioid hit the market, designed to address some of the these issues - Suboxone. Suboxone is a trade name for a drug made up of 4 parts of an opioid called buprenorphine and one part opioid antagonist, naloxone. While buprenorphine has a very strong affinity for its receptor, it is only activates it partially. In theory, this means that it will hog up all the receptors if a person decides to use it simultaneously with a full activator like heroin, but it won't have as powerful an effect.

The addition of naloxone, an antagonist that attaches to receptors and prevents them from being activated, is to prevent people from injecting Suboxone. When the formulation is crushed and injected, the naloxone is designed to block many of the receptors, essentially causing a user to suffer a very unpleasant or, even, severe withdrawal.

Suboxone can be taken in pill form and there's a new film form - both are meant to be absorbed under the tongue.

Additionally, under the Drug Treatment Act 2000, specially licensed doctors can prescribe buprenorphine from their offices, instead of clinics. They often very quickly begin giving their patients a one month supply to take at their own convenience at home. Patients don't have to deal with the inconvenience and stigma of making daily visits to a clinic. Suboxone was approved under the DTA 2000 in 2002.

Many users also report feeling more confidant, almost like their "old selves", with Suboxone. Since Suboxone is only a partial agonist, it also causes a milder "high" and is not as prone to abuse or overdose. But, like methadone and heroin, Suboxone can cause side effects like nausea, vomiting and constipation. Moreover, at least one experienced professional worries that doctors who prescribe Suboxone are not properly trained in important supplemental therapies like addiction counseling. At $200-$300 per office visit, many providers also may not have much of an incentive to wean their patients from the treatment.

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What is Buprenorphine?
 Buprenorphine is an FDA approved opioid addiction treatment. Currently Subutex® & Suboxone® are the only Buprenorphine medications approved by the FDA. Buprenorphine itself is opioid itself, but the maximal effects are less than other more dangerous opioid agonist like methadone and herion. By producing enough agonist, individuals taking Buprenophine that have become addicted to other opioids are able to discontinue abuse with minimized withdrawl side-effects. In 1965, K.W. Bentley discovered the class of compounds synthesized from an alkaloid of thebaine, the opium poppy plant, known as Papaver somniferum. Among these semi-synthetic compounds is Buprenorphine - the first in a series of opioid agonists. Many were more than 1000 times more effective than the analgesic, morphine. In the 1980s, Reckitt & Colman, today known as Reckitt Benckiser, introduced Buprenorphine hydrochloride for sale. Buprenorphine, an analgesic, was first made in sublingual tablets of 0.2 mg (Temgesic). It was also made as an injectable of 0.3 mg/ml (Buprenex). Read More...

What is Suboxone®?
 Suboxone® is the first narcotic drug available for prescription from a doctor's office for use in the treatment of opioid dependence under the Drug Addiction Treatment Act of 2000 or DATA 2000. The primary active ingredient in Suboxone is Buprenorphine, which itself is a partial opioid agonist. This means the the opioid effects and withdrawal symptoms from Buprenorphine are less than other full opioid agonists such as heroin, methadone, morphine, oxycodone, hydrocodone, codeine, and others. Suboxone, taken as sublingual tablets or "under the tongue", has been shown to help in suppressing opioid withdrawal symptoms, decrease illicit opioid cravings and use, and under the correct supervision can help with overcoming an opioid dependence. Suboxone comes in 2mg and 8mg sizes of sublingual tablet form. Suboxone contains naloxone, which blocks the effects of medicines and drugs like methadone, morphine, and heroin. This is added to prevent people from injecting Suboxone and improper use of the medication. Injecting naloxone can cause withdrawal symptoms. Suboxone is the most commonly prescribed medication and given to patients during the maintenance phase of treatment. Subutex is typically given during the first couple of treatment. Because Suboxone has a lower potential for overdose and abuse, unlike methadone, Certified Doctors are able to prescribe take home supplies of Suboxone in certain circumstances. Read More...

The Benefits of Medication Assisted Treatment for Opioid Addiction
 Since 1949, the 12-step program developed by Alcoholics Anonymous has been the dominant way we think about facing and fighting addiction. Many people have successfully used this community- and willpower-based approach to escaping addiction. However, countless others have tried it, and relapsed. With the powerful hold that opioid addiction has on so many people in America, it’s time to face addiction with an equally powerful—and proven—method: medication-assisted treatment (or MAT). MAT is the practice of using drugs like suboxone and subutex to help people dependent on painkillers gradually ease themselves off their addiction. While these treatments have been available for many years, there is a stigma to relying on these medications to help fight addiction rather than the traditional willpower and community approach of a 12-step program. Here are five benefits to using an MAT approach to ending opioid dependency:
1. MAT is proven to have better results than conventional programs alone.
2. MAT stops withdrawal symptoms so patients can live a normal life.
3. MAT is flexible, allowing medication to be taken at home or in a clinic
4. MAT offers multiple drugs (like suboxone and buprenorphine) to find what works for you
5. It’s easy to find an MAT/suboxone provider near you Read More...