Answer Addiction

Tag: suboxone use

  • Is Bunavail like Suboxone?

    Yes and no.

    Suboxone and Bunavail are Schedule III narcotics that contain a combination of buprenorphine and naloxone as active ingredients. Both these meds are prescribed in the treatment of opioid addiction. The buprenorphine in these medications is an opioid, while the naloxone is substance that reverses the effects of opioid drugs. The combination is made to lower the chances for abuse and addiction to buprenorphine.

    They may seem to be the same drug under a different brand name, but Suboxone and Bunavail have their significant differences. Continue reading as we get into the details about these medicines and compare their effects. If you have any questions and comments, you can post them in the section at the end of the page.

    Bunavail and Suboxone similarities

    Suboxone and Bunavail are different from current medications (like methadone) used in the maintenance phase of opioid addiction treatment. They are more convenient, are prescribed in doctor’s office, and are available in most commercial pharmacies. As patients progress in therapy, they may even be allowed to take a supply of the medication and use it at home.

    Note here that both Bunavail and Suboxone are not intended to be used as stand alone treatments. Instead, medication should be combined as a part of a complete treatment program that includes counseling, individual, group or family therapy sessions, cognitive-behavioral and educational classes, psychological support, and adopting new, positive life-style practices.

    Bunavail and Suboxone: How supplied and dosing

    Suboxone is supplied in the form of sublingual tablets, taken by placing the tablet under the tongue and waiting for it to dissolve. Suboxone is available in two strengths:

    • 2 mg buprenorphine/ 0.5 mg naloxone
    • 8 mg buprenorphine / 2 mg naloxone

    Bunavail, on the other hand, is made of a buccal film that stick to the mucosa on the inside of the cheek and are then quickly dissolved. Bunavail is available in three different strengths:

    • 2.1 mg buprenorphine/0.3mg naloxone
    • 4.2 mg buprenorphine/0.7mg naloxone
    • 6.3 mg buprenorphine/1mg naloxone

    Bunavail and Suboxone differences

    1. Mode of administration/delivery mechanism

    One of the main differences between these two medicines is that Bunavail buccal film delivers buprenorphine through the buccal mucosa, while Suboxone is taken sublingually (put under the tongue). Bunavail offers delivers a dose of buprenorphine to the bloodstream via a polymer film that attaches to the buccal mucosa at the inside of the cheek. The film will disappear within 15-30 minutes, it has a pleasant taste and doesn’t disrupt swallowing or speaking while dissolving. However, speaking is not as easy with Suboxone sublingual.

    2. Bioavailability

    You have probably noticed that Bunavail comes in lower dose strengths than Suboxone. Taking one Bunavail 4.2 mg/0.7mg buccal film will provide equivalent level of buprenorphine in the system as taking 8mg/2mg Suboxone sublingual tablet. The level of naloxone supplied with Bunavail buccal film is about 33% lower than naloxone levels supplied by Suboxone sublingual.

    It doesn’t make Bunavail less effective in the maintenance treatment for opioid dependence. Instead, Bunavail buccal film is designed with the new BEMA delivery technology or BioErodible MucoAdhesive drug delivery mechanism. This allows Bunavail to be absorbed more quickly than Suboxone, so patients need a lower dose to achieve the same effects.

    However, this difference in bioavailability between Bunavail and Suboxone requires a different dosage strength to be administered by patients who are switching from one to the other (generally from Suboxone to Bunavail). It’s important for doctors to prescribe dosage strengths that will correspond to the amount and strength in which the other medication was taken.

    3. Less risk

    Taking your maintenance medication in lower doses, while achieving the same medical effects is great because you have less chances of developing cross-addiction and getting unwanted side-effects.

    Bunavail v.s. Suboxone questions

    We hope we answered all you wanted to know about the similarities and differences between Suboxone sublingual tablets and Bunavail buccal film. Keep in mind that a doctor’s clearance and approval are crucial for prescribing either one of these medications, and for switching from one to the other.

    If you have any further questions you’d like to ask us, please post them in the section below and we’ll do our best to provide a personal and prompt response.

    Reference Sources: PBM: Buprenorphine/Naloxone Buccal Film (BUNAVAIL )
    FDA: BUNAVAIL (buprenorphine and naloxone) buccal film
    NCBI: New Drug Approvals: New Formulations: Bunavail for Opioid Dependence; page 5
    NC State Health Plan: Buprenorphine tablets and Buprenorphine/Naloxonetablets/films

    View the original article at addictionblog.org

  • Is buprenorphine an antidepressant?

    Is buprenorphine an antidepressant?

    Can Suboxone treat both opiate addiction and depression at the same time?  Dr. Burson says, “No. Buprenorphine is not an antidepressant”.  But should your Suboxone doctor consider using this opioid to treat the disease of depression? Maybe.  Read more about the potential of buprenoprhine as an antidepressant during opiate withdrawal here.

    What is the disease of depression?

    When doctors talk about the disease of depression, we aren’t speaking of a bad feeling that we all get when having a terrible day. Doctors consult a set of diagnostic criteria that describe a situation of chronically low mood, significant enough to cause considerable suffering. In patients with major depression, we see feelings of low self-worth, hopelessness, and even suicidal thoughts. People with the disease of depression don’t feel pleasure from previously pleasurable activities. We believe this kind of depression is caused by an imbalance of brain chemicals. In the past, scientists thought that the main chemicals affecting mood are serotonin and norepinephrine, and our presently available antidepressants work by adjusting these brain chemicals.

    But over the years, it’s gotten more complicated. As science evolves, we’ve begun to see that other brain chemicals affect mood. For example, estrogen and testosterone, the sex hormones, affect mood.  Also, the stress hormones like cortisol play a role in the control of mood, and also may be a factor in the development of addiction.

    Can opioids affect mood?

    The research on mood and addiction overlap.  Addiction and the brain are interrelated, as are mood disorders and the brain…suggesting future discoveries about how mood disorders and addictions are related. Researchers know that we make our own opioids, called endorphins, which affect mood. At present, we don’t have a way to measure these endorphins, but some scientists believe it’s possible that some people are born with low levels of endorphins. When they use opioids, perhaps they feel “normal.” Without opioids, they may feel chronically low in mood. Perhaps opioids help these unfortunate people to feel like people born with adequate endorphins. This is an exciting area of research, which may help us understand why some people are much more susceptible to addiction than others.

    People who have become addicted to opioids experience withdrawal when they don’t have access to their drug of choice. Besides the physical symptoms, which can be quite severe, many addicts also feel depressed and anxious. When they use an opioid, those bad feelings go away, along with the physical symptoms. So opioids elevate a depressed mood, but the depressed mood was caused by addiction to opioids in the first place. This is the official answer to the question of why some people feel less depressed when taking Suboxone. But it’s probably not so simple.  And to find Suboxone doctors taking patients, you’ll need to look at the SAMHSA listing for buprenorphine physicians or check out the Suboxone manufacturer’s website for more information.

    Is buprenorphine / Suboxone an antidepressant?

    No. Strictly speaking, Suboxone, which is the brand name of the generic drug buprenorphine, is not an antidepressant.

    However, Suboxone is an opioid. All opioids, by stimulating opioid receptors, create feelings of expansive well-being, and even euphoria. This is the “high” that some people become addicted to. If someone is in a foul mood, using an opioid usually produces a much better mood. Suboxone, since it’s only a partial opioid, causes less euphoria, but still can cause this good feeling.  Doctors further prescribe buprenorphine sublingual tablets during opiate withdrawal or for opiate addiction maintenance programs, as its effects are relatively mild and supportive of a better lifestyle.

    Discussion

    Should we consider treating depression with opioids?

    View the original article at addictionblog.org