In response to this growing public health concern, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2002, the U.S. Food and Drug Administration (FDA) approved two sublingual buprenorphine products for the treatment of opioid dependence: Subutex, which is buprenorphine, and Suboxone, a mixture of buprenorphine and naloxone.
Buprenorphine is a partial opioid agonist drug with a long half-life; this means it stays in the bloodstream for 24-72 hours, the Drug Enforcement Administration (DEA) reports. While it is an opioid, and it does block pain receptors and induce a mild euphoria, this effect is thought to plateau if large doses are taken, meaning that after a certain amount, it will no longer produce any effect. The addition of naloxone to buprenorphine in Suboxone is meant to act as an abuse-deterrent, as naloxone is an opioid antagonist. When taken as directed, the naloxone remains dormant; however, if the drug is altered and then injected or snorted, the antagonist blocks opioid receptors, and it can induce opioid withdrawal syndrome.
Suboxone may be abused by individuals battling addiction to a short-acting opioid drug like heroin, by using it in between doses to keep withdrawal symptoms from occurring. The Washington Post postulates that “Subs,” as Suboxone is often called on the street, is more commonly abused for this purpose than to get high. The medication can still produce a euphoric effect, as it still acts on the same opioid receptors in the brain and creates a flood of dopamine in the brain. This high may be less intense than other full agonist opioids, but it may last longer. On the street, Suboxone may also be called:
Suboxone is meant to be used as a component of a drug abuse treatment program, although it still has abuse potential; therefore, its use needs to be closely monitored.
It should only be used in combination with addiction treatment services, such as counseling and ongoing support, in order to reduce its abuse, the Courier-Journal publishes.
Suboxone may also be becoming a preferred drug of abuse for individuals seeking an opioid-like high, and many may be choosing this drug over other opioids. Suboxone abuse may be common among incarcerated inmates. It is smuggled into prisons and jails on stamps and coloring pages, with the film strips embedded into the pages, or the tablets are crushed, made into a paste, and smeared onto the pages or the backs of stamps. The New York Times reports that as much as 12 percent of all confiscated contraband in state prisons in Massachusetts involves Suboxone.
Buprenorphine emergency department (ED) visits for nonmedical use of the drug have increased fivefold from 2005 to 2011 – up to more than 20,000 ED visits involving buprenorphine products for nonmedical purposes, the DEA publishes. Individuals who are not tolerant or dependent on other opioids may prefer the more mellow “high” produced by Suboxone than stronger opioid drugs. It also may be more readily available or cheaper to buy illicitly than other prescription opioids.
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