From WikiHealth

Suboxone or buprenorphine

What is it?

Suboxone is a partial-agonist that acts on the mu opioid receptor. It is the first office-based treatment for opioid dependence. The Drug Addiction Treatment Act of 2000 allows doctors to treat patients suffering from opioid dependence out of their offices, in the same way that physicians treat other chronic illnesses like diabetes and mood disorders. Suboxone is 4:1 buprenorphine/naloxone. Subutex is the monotherapy which consists of buprenorphine only. Both formulations are sublingual tablets that are dissolved under the tongue. Naloxone is inactive when the individual takes the medicine correctly, i.e. sublingually, but if the individual tries to crush up Suboxone and inject it or snort it, the naloxone becomes active and will precipitate a severe withdrawal. Naloxone was added to buprenorphine to discourage diversion and abuse of the medicine. Diversion has been reported but it is usually diverted for therapeutic means, i.e. a friend will offer a friend who is in active opioid withdrawal some Suboxone or Subutex which will decrease withdrawal symptoms and suppress cravings.

Condition(s) it is used for

Suboxone and Subutex are indicated for opioid dependence.

Some physicians use it off label for pain management.

How it works

Suboxone and Subutex decrease withdrawal symptoms and suppress cravings. They cause little sedation, euphoria, constipation, urinary retention, or miosis.

When a patient is in opioid withdrawal they can take Suboxone and it will relieve them of their withdrawal symptoms within 20 minutes of administration. The Suboxone attaches to the mu opioid receptor and provides some effect, but not a full effect. For this reason Suboxone and Subutex are considered partial agonists, while heroin, oxycontin, vicodin, methadone and morphine (as well as other pain medications) are full agonists.

Side effects

Headache
Withdrawal syndrome
Pain
Nausea
Insomnia
Sweating

Contraindications

Make sure to check with your doctor or the medication pamphlet on contraindications and drug interactions.

Benzodiazepines should be used with caution but are not contraindicated.
Subutex, not Suboxone, should be considered for use in pregnant women.

Common brand names

Suboxone (4:1 buprenorphine:naloxone) Available in 2 and 8 mgs sublingual tablets
Subutex (buprenorphine) Available in 2 and 8 mgs sublingual tablets

Availability

Available via prescription from a DATA 2000 waivered physician who is certified to prescribe Suboxone for opioid dependence.

References

More Information

The following list is the best physician locator for Suboxone providers in the San Francisco Bay Area:

San Francisco Proper

John Mendelson, MD 909 Hyde Street, Suite 210 San Francisco, CA 94109 Tel: 415-474-7900 Internal Medicine

Carolyn Schuman, MD 450 Sutter Street, Suite 300 San Francisco, CA 94108 Tel: 415-788-0500 Addiction Medicine

Raymond Deutsch, MD 1700 Montgomery St. Suite 215 San Francisco, CA 94111 Tel: 415-288-0404 Addiction Medicine

Dan Kalshan, MD 220 Montgomery St. Suite 1212 San Francisco, CA 94104 Tel: 415- 433-7000 Internal Medicine

Veteran�s Administration: David Kan, MD 4150 Clement St. San Francisco, CA 94121 Tel: 415-221-4810 x2823

Marin County

Michael Chiarottino, MD 1750 Bridgeway Avenue Sausalito, CA 94965 Tel: 415-331-2113 Pain Management/Addiction Medicine

Howard Kornfeld, MD 3 Madrona Street Mill Valley, CA 94941 Tel: 415-383-2949 Pain Management/Addiction Medicine

Timmen Cermak, MD 239 Miller Avenue, Suite 1 Mill Valley, CA 94941 Tel: 415-381-4009

Anna Vertkin, MD 591 Redwood Hwy, Ste. 5215 Mill Valley, CA 94941 Tel: 415-389-6411 Internal Medicine