*In October 2002, the Food and Drug Administration (FDA) approved buprenorphine monotherapy product, Subutex®, and a buprenorphine/naloxone combination product, Suboxone®, for use in opioid addiction treatment. The combination product is designed to decrease the potential for abuse by injection. Subutex® and Suboxone® are currently the only Schedule III, IV, or V medications to have received FDA approval for this indication. Note that aside from Subutex® and Suboxone®, other forms of buprenorphine (e.g., Buprenex®) are not approved for treatment of opioid addiction.
*The FDA approval of these buprenorphine formulations does not affect the status of other medication-assisted opioid addiction treatments, such as methadone and LAAM (levo-alpha-acetyl-methadol). As indicated in Title 42 Code of Federal Regulations Part 8 (42 CFR Part 8), these treatments can only be dispensed, and only in the context of an Opioid Treatment Program.
In the late ‘90s we began seeing the use of Suboxone primarily, because of its built in abuse protection. In Treatment programs it worked well for Opiate addicts and was helpful in Detox. However, something different was going on – Doctors were able to have up to 30 patients in their practice on Suboxone in an Outpatient manner, today that has gone up to 90 patients.
Suboxone is a very strong Schedule III Narcotic, yet Dr.s can dispense to up 90 patients, most as cash only, costing as much as $500 per visits and visits usually are monthly. With this Model what is the incentive for Dr’s to detox down and let the patient move on. In Treatment Patients are off of Suboxone within 7-11 days and totally drug free.
Suboxone is being called a mood stabilizer a miracle drug that keeps addicts Opiate free and in year or two they can come off. Problem is we have litteraly tens of thousands of Men and Women in 12 Step Programs, afraid to talk about being on suboxone beceuse long term use is seen as using, and they cannot get off of suboxone. They can get down to 1 or 2 mg’s yet when they try to get off from there they cannot and cannot find the support.
So it seems that a drug that is great for Detox is making its way into mainstream abstinence and by way of this route through the Dr.s Office into our High Schools.