Bupe, Buse, Sobos, Subs, Stops, Strips, Subox, Sabaxin, and Subs.
What is Subox, and why is it showing up in discussions about opioid dependence treatment? Are all of these unusual names describing the same drug?
One issue that comes up in discussing medication assisted treatment with buprenorphine, the main active ingredient in Suboxone, is confusion over the medication names. Any confusion about these life-saving drugs and their names is understandable.
Drug names in general tend to be confusing. First, every drug has a generic name, and also various brand names. A single generic can have multiple brand names.
For example, buprenorphine, combined with naloxone, is known by the names Suboxone, ZubSolv, and Bunavail. Buprenorphine by itself is known by brand names such as Subutex, Sublocade, Brixadi, Buprenex, and Probuphine.
Of the product names listed above, some are available as sublingual films, or strips. They are also available as sublingual pills, or tablets. “Sublingual” means that the pill or strip is placed under the tongue to dissolve.
Others are time-release injections, such as Sublocade and Brixadi. Probuphine is a six-month implant.
Why do people call buprenorphine “bupe”?
“Buprenorphine” is a difficult word to pronounce. It looks like it should be pronounced similarly to “morphine,” but it is a very different word. It starts with “Bupre,” and ends with “norphine.”
The “bupre” part is the difficult part of the word to say, in my opinion. That’s why, I think, people have naturally shortened the whole word to simply, “bupe.”
While I have not heard anyone refer to it as “buse,” I have heard and read bupe fairly frequently. In fact, I have referred to it as bupe in some of my writing.
Subs are bupe strips and tablets, not sandwiches.
Suboxone has become something of a household name. People generally refer to the entire category of sublingual forms of buprenorphine as “Suboxone.”
Doctors who prescribe buprenorphine are known as Suboxone doctors, and clinics that treat opioid addiction are called Suboxone clinics. Of course, it is natural for people to shorten Suboxone to “subs.”
Suboxone films are often referred to as strips. They are small rectangles that come individually wrapped in a foil wrapper. They look like little rectangular strips.
Calling them films may seem too formal, or possibly, since cameras no longer use film, people are not as familiar with the term film. Either way, Suboxone doctors will know what their patients are talking about.
What about Subox and Sabaxin?
I have received emails and voicemails from people clearly pronouncing, and also spelling Suboxone as Sabaxin. I’m not sure where this one came from, but possibly it is another example of people taking the word and making it their own by putting a spin on the pronunciation and spelling.
Subox is a new spelling I have been seeing used in ads for Suboxone therapy online. It could possibly be used as a way to subvert Google advertising rules.
Advertisers are not supposed to advertise drug names unless they have a pharmacy registration. Google, and other ad platforms, such as Facebook, are very sophisticated. They probably are already prepared for slang and alternate spellings, such as Sabaxin, Subs, Bupe, and more.
Yet, Subox may still not be on their radar, so it slips by the automated ad filters. Of course, they will soon catch on, and the advertisers will have to figure out new ways to slip Suboxone strip references into their ads.
How can I find a Sub doc near me who prescribes bupe?
The persistence of shortening words reminds me of a memory from college when a friend loudly announced that he was ordering a “za.” I had no idea what a za was, until it arrived, and I realized that it was a pizza!
How hard would it have been for my friend to say the entire two syllables? I think that there is also an element of being cool, using slang and shortened words.
In some recovery groups, members warn newcomers of being “hip, slick, and cool”, or of being “terminally hip.” While some of these terms sound like they come out of Happy Days, a show that romanticized the 1950s, the meaning is clear.
When people who use drugs and are caught up in the street drug culture are too concerned about image and how cool they appear to be, they may see recovery as seeming uncool. Yet, being uncool in recovery can save your life.
Should Suboxone doctors enforce the proper terminology for buprenorphine medications?
On one hand, it may make sense that a doctor who provides medication assisted treatment for opioid use disorder should ask that their patients not use slang for buprenorphine drugs, or any other drugs. Trying to act cool, like Fonzie from Happy Days, can work against a person’s recovery.
Getting away from street culture and slang may help a person re-align their life with new recovery-focused values. In recovery, being uncool becomes the new cool.
On the other hand, we must always keep in mind the concept of harm reduction. While it might be a good idea to ask patients to not use drug slang, it is more important to meet them where they are at, and ensure that they have access to treatment.
It would be better not to scare a patient away with excessive, and possibly unnecessary strictness, especially early on in recovery. So, maybe we don’t need to get bent out of shape when patients call their meds, bupe, subs, strips, oranges, subaxin, or any other slang or affected version of treatment drug names.
Subox or Suboxone: It’s all the same.
Most importantly, our goal should be to help people get into recovery and off of street opioids, such as fentanyl, heroin, and oxycodone. By working with patients in a compassionate and understanding manner, we can help them to achieve their goals of recovery.
It is also important for healthcare workers to keep up with the street terminology used by patients. This includes street names for opioids, such as Captain Cody, H, Oxys, Roxys, Blues, and 30s.
By learning the language, healthcare workers in the field of addiction treatment will have a better understanding of what their patients are going through and how to best help them. It only takes a small effort to pay attention, listen, and learn from our patients.