Touted by Congress as a miracle drug for heroine addiction treatment – buprenorphine – most commonly prescribed as Suboxone, was introduced to the American public in 2003. The idea seemed a good one: extend treatment options for opiate addiction (heroine or prescription pain killers) beyond specialized clinics to include private physicians' offices. And the drug held promise: it would be a replacement medication, like methadone, to relieve cravings and the painful effects of withdrawal as the patient comes down from the addiction, with only a "limited" euphoric effect. Such were the hopes at least behind Suboxone in 2003. But few today are quite so eager about it, and no one's calling it a miracle drug.
Unlike methadone, which is distributed in daily doses within federally controlled facilities, Suboxone is a prescription medication. And as physicians nationwide have been strongly and steadily encouraged to prescribe the drug, it's found its way into a great many medicine cabinets. This wide availability has, for 5 years now, been creating its own set of problems, most of them unforeseen by the lawmakers who first approved the sale of buprenorphine in 2000.
One of the first problems was in its formulation. Suboxone is a small, orange pill in the shape of a stop sign, designed to be dissolved under the tongue. US officials, to prevent it from being snorted or injected, required the producer of Suboxone, Reckitt Benckiser Pharmaceuticals, to add naloxone, a compound that makes users who inject the drug become sick. But "street" chemists very quickly found simple ways of filtering out the naloxone from the crushed pills so they could be injected or snorted, and a new street drug was born, paid for by US taxpayers and as addictive as any other opiate-derivative.
Another problem is common to all prescription opiates—the street market. Some patients sell all or part of their Suboxone prescriptions to buy other drugs, often the very drug for which they purported to need addiction treatment in the first place. And in some cases, taxpayers are subsidizing such schemes because Medicaid is picking up the prescription costs. Well-meaning doctors can try to curb this activity by randomly calling in patients for pill counts. And it works for a while, until users begin renting their pills to each other. The street market is a sophisticated economy, and "bupe" at street level is on the rise.
But for all the hype, promise, political currency, and millions of federal dollars behind it, Suboxone has an even bigger problem in that it fails to do the very thing it was created for—to free the addict from opiate addiction. Today, what some call the "bupe method" of drug-addiction treatment is doing for addicts what methadone clinics have been doing since 1973—taking one addiction in trade for another. Suboxone, whether it's used legally or illicitly, is a highly addictive opiate. And addiction to Suboxone requires the same attention as would addiction to heroine or prescription pain-killers. But replacement therapy is not—and has never been—the answer.
If you or some one you care about is struggling with an addiction to Suboxone, or to any opiate drug, please help them now.