The other side of Suboxone

The other side of Suboxone – KevinMD – July 2018 – by Dennis Wichern

There are no good or bad opioids, there are only good or bad ways to use them.

A lot has been written about Suboxone, the buprenorphine treatment drug.

For many, Suboxone acts as an effective medication to treat opioid addiction.

For others, it’s a highly-valued street drug that is commonly diverted and misused. To understand and acknowledge the darker side of Suboxone we have to look back at its history over the past 16 years.  

History of Suboxone

Suboxone was first approved by the FDA in 2002 to treat opioid addiction in office-based opioid treatment programs.

Suboxone was initially manufactured in tablet form but was subsequently changed to a dissolvable oral filmstrip in 2010.

Currently, over 35 states have filed lawsuits against the drug’s manufacturer alleging antitrust violations regarding the tablet to film reformulation.

Prison heroin

Suboxone smuggling into correctional institutions is a significant issue across the nation with the drug oftentimes hidden in books and letters because of its filmstrip form

In a subsequent 2013 Times article, Suboxone was referred to as “medication and dope” and “a treatment with considerable successes and also failures, as well as a street and prison drug bedeviling local authorities.” The same article dubbed the drug “prison heroin” because inmates were using it to get high, instead of its intended helpful use.

On July 1, 2016, Maryland’s Medicaid program stopped allowing Suboxone strips in an effort to stop the illicit flow of the drug into jails and prisons.

Zubslov, a tablet containing buprenorphine and naloxone was added to the program’s formulary as an alternative treatment drug.

A new type of pill mill?

The emergence of Suboxone has also brought unscrupulous providers into the opioid treatment profession who operate cash-only prescription clinics with some calling this phenomenon, the second coming of the old pill mills.”

Why is this happening?

Street value.

Suboxone is a valuable drug on the street and is used by those with an opioid use disorder to experience its euphoric effect, prevent opioid withdrawal, profit off its sales or to self-medicate.

in 2017 the University of Kentucky published a study which found that out of 1,675 substance users,

985 reported taking Suboxone at some point, with

  • only 6% receiving it by prescription,
  • 62% by illegal means and
  • 32% both ways.
  • Nearly80% of those who received it both illegally and by prescription admitted selling, trading or giving away what they were prescribed.
  • More than 75% admitted mixing Suboxone with other drugs or alcohol to get high.

Suboxone and other buprenorphine medications are important tools in a treatment provider’s toolbox but prescribing only medication— without any other treatment support — is short-changing those in need.

Author: Dennis Wichern is a retired DEA agent.

7 thoughts on “The other side of Suboxone

  1. lingeringson

    Can someone please explain how people are getting ‘high’? I read that the buphrenorphine satisfies the receptors, and naloxone counteracts any benefit. I’m confused. It sounds like addicte ‘treated’ with suboxone are really able to get their drug without risk of overdose? How is this ‘recovery’? If they stop suboxone they have withdrawals, right?
    I see heads nodding, but few really understand.

    Liked by 1 person

    1. Zyp Czyk Post author

      I think they don’t get high from it, but it does help prevent withdrawals. When you depend on illicit drugs the supply might not be steady and Suboxone can get you through times you can’t find anything else.


      1. lingeringson

        Suboxone is a valuable drug on the street and is used by those with an opioid use disorder to experience its euphoric effect, prevent opioid withdrawal, profit off its sales or to self-medicate.”

        Is an ‘euphoric effect’ not a high?
        I’m trying to understand the mechanism. How does this fit into drug treatment if it gives an euphoric feeling? Yes, it curbs cravings. So will any opiate. And added does it allow euphoria, yet block OD?

        Liked by 1 person

        1. Zyp Czyk Post author

          You’re right. I’m not sure either. I think the researchers are wrong about illicit drug users getting high from it – they assume we pain patients get high from our meds too.

          The regulators seem to get upset thinking that anyone might be having a good time without “earning” it by takin some medication – they are just small angry people trying to spread their version of a fantasy: a drug-free world.


  2. Pingback: The other side of Suboxone | EDS and Chronic Pain News & Info – The War on Chronic Pain Patients

  3. Pingback: HHS Guidance for Dosage Reduction | EDS and Chronic Pain News & Info

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