How Much Naltrexone Is In Suboxone?

Why do they put the blocker drug in the Suboxone Film?

When it comes to opioid receptor blockers and Suboxone, there is often confusion. Suboxone actually contains two blockers. One keeps you from getting withdrawal symptoms and cravings, the other is there to prevent you from abusing Suboxone. Even doctors sometimes get it mixed up. Adding a drug to another drug as an abuse-deterrent is, by itself a strange and confusing topic. While the extra blocker in Suboxone is usually not harmful at all, it can seem unusual to patients to discover that their medication has an extra drug in it that provides no benefit to their health.

Which blocker in Suboxone will keep me clean from opioids?

The main ingredient is buprenorphine. While buprenorphine is a powerful opioid receptor blocker, it also has the additional effect of activating the receptor partially. This combined action is what makes buprenorphine both safe and effective. Other opioids fully activate the receptor without blocking which makes them more dangerous and addictive. Buprenorphine is quickly becoming the preferred drug of choice in treating opioid addiction, even replacing methadone in many cases.

Is naltrexone the other blocker in Suboxone?

Actually, Suboxone does not contain naltrexone at all. The names of some of these drugs are similar, so it is not hard to get them mixed up. The other blocker in Suboxone is naloxone. Naloxone is a very powerful blocker of the opioid receptor. It is present in Suboxone in small amounts. For example, an 8mg/2mg Suboxone film contains 2mg of naloxone. When you hear about naloxone, you may associate it with Narcan. Narcan is a brand name version of naloxone that is used to treat opioid overdose. Naloxone in this form comes as either an injectable or a nasal spray. When a person is experiencing an overdose, from heroin, for example, naloxone will reverse the side effects of the opiate and resolve the breathing problems caused by the overdose. Naloxone will also cause the person to go into opioid withdrawal. Naloxone works by injection or nasal spray. It does not work when placed under the tongue or swallowed. Very little is absorbed if naloxone is taken in by those routes. Because of this, naloxone usually has no effect as an ingredient in Suboxone when the patient places the Suboxone film under their tongue as directed. However, if a drug abuser attempts to shoot up their Suboxone, the naloxone will cause opioid withdrawal.

What is naltrexone and what is it used for?

Not only is the name of naltrexone similar to naloxone, but it also works in a similar manner. Both are strong opioid blockers. And, neither activates the receptor at all. A major difference is that naltrexone works fully when swallowed as a tablet. Because of this, it would not be useful as an abuse-deterrent in the way that naloxone is used. However, naltrexone is a very useful drug. It can be used to treat alcoholism and opioid addiction. Naltrexone, by blocking opioid receptors over a period of hours, has the effect of reducing cravings for opioids and alcohol. It also reduces the pleasure that alcoholics get from drinking. Naltrexone is a highly useful addiction treatment drug that was almost forgotten and is now enjoying renewed interest.

Is addiction treatment with buprenorphine better than with methadone?

There are definitely advantages of medication-assisted treatment (MAT) with buprenorphine-containing drugs compared to methadone. In the Suboxone vs methadone comparison, the advantages are that patients can see their Suboxone doctor weekly or monthly in many cases, compared to daily visits for methadone. Also, it is easier for a doctor to get certified to prescribe Suboxone, making it easier to find a doctor who can prescribe it. Finally, buprenorphine is safer. That is a big part of why it is approved for more widespread use over methadone. Yet, methadone has its advantages as well. It has a higher success rate overall compared to buprenorphine. It is generally considered to have a 75% success rate, compared to 50% for Suboxone. And, methadone can be taken sooner after the patient stops taking opioids.

How many different drugs are available for treating opioid dependence?

There are a total of three approved MAT drugs. There is methadone, which is dispensed at special clinics on a daily basis so that patients do not take too much and go into respiratory depression and overdose. Then, there is buprenorphine a partial agonist and antagonist of the opioid receptor and the main ingredient in the Suboxone sublingual film and ZubSolv. Finally, there is naltrexone, available as a generic tablet and the monthly Vivitrol injection. While there are other promising therapies for opioid addiction, these are the three drugs available today in the US for opioid addiction treatment. 

Is buprenorphine treatment always sublingual? 

While the most common way that buprenorphine is prescribed is as a sublingual tablet or film, there is also a monthly injectable form. The injection is called Sublocade, made by Indivior. Soon, there will also be a competing buprenorphine injection called Brixadi. If you are interested in medication-assisted treatment for opioid addiction, ask your doctor if buprenorphine, as a sublingual film or tablet, or as a monthly injection, might be the right choice for you.

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