The opioid crisis began in the mid-1990s when waves of deaths were linked to the use of opioids. Since that time, demand for treatments that deal with substance use disorders has arisen.
Among these treatments (and especially within Medication-Assisted Treatments (MAT)), Suboxone has emerged in both pill and strip forms.
So, what purpose do Suboxone pills serve? In this article, we’ll delve deeper into:
- What Suboxone pills are
- How to take them properly
- What their status is today.
Let’s get started.
What is Suboxone?
Suboxone is a prescribed medication that treats Opioid Use Disorders (OUDs).
The drug’s formation and inclusion into healthcare dates back to the beginning of the opioid crisis, and primary care providers can now supply it as part of a long-term Medication-Assisted Treatment plan (MAT).
Suboxone contains the combination of Buprenorphine and Naloxone, acting as an μ-opioid agonist and antagonist respectively.
These ingredients help with reducing withdrawal symptoms, cravings, and the effects of opioid overdose.
Overall, Suboxone has been shown to help greatly in transitioning patients into a life of sobriety in a way that doesn’t force them to do so “cold turkey”. The Suboxone treatment plan is usually safe and well-managed.
What are Suboxone Pills?
Doctors can prescribe Suboxone pills or sublingual tablets to patients with opioid dependence.
Suboxone pills have the appearance of small hexagons with imprinted letters and numbers. The letters and numbers represent Buprenorphine and Naloxone content.
Physicians can adjust and vary the doses throughout treatment, but they generally recommend a daily target of 16 mg/4 mg of Buprenorphine/Naloxone.
Primary health care providers who have qualifications that meet the Drug Addiction Treatment Act can prescribe the medication.
Suboxone Pills vs. Strips
| Suboxone Pills | Suboxone Strips (Films) | |
| Administration | Placed under the tongue for dissolution. | Sublingual or buccal administration. |
| Form | Solid tablet. | Thin, orange, rectangular soluble film. |
| Taste | Unpleasant bitterness. | Unpleasant bitterness (possibly stronger). |
| Storage | Store below 86°F, in original packaging. | Store below 77°F, protect from moisture. |
| Availability | Limited due to discontinuation. | Easier to access, available in 48.3% of US pharmacies. |
Suboxone Pills
Administration: Suboxone pills are intended to be placed under the tongue as suggested by the term ‘sublingual tablets’ in its given leaflet.
This is so the pill can dissolve efficiently into the bloodstream. It is advised that patients do not swallow the pills whole as doing so will not allow the medication to be absorbed as effectively – potentially resulting in stronger opioid withdrawal symptoms.
–Form: Suboxone pills are in a solid tablet form.
Taste: Patients often associate the taste of Suboxone pills with an unpleasant bitterness.
Storage: Suboxone pills have straightforward storage instructions. Patients should store them below 86 °F and in their original packaging.
Availability: In 2012, Reckitt Benckiser announced the discontinuation of the supply of suboxone tablets.
This decision was based on the higher rates of pediatric exposure that were occurring with the pills but not the film/strips.
Although pills can still be dispensed until alternatives are found or supply runs out, the availability of the pills across the United States may be limited for this reason.
Suboxone Strips (Films)
Administration: Suboxone film should only taken via sublingual or buccal administration as other methods such as swallowing reduce the bioavailability of the drug.
Sublingual administration involves putting the film under the tongue until it dissolves, while buccal administration involves putting the film in the sides of the cheeks.
Switching between either method is safe, as there is no significant difference in Buprenorphine exposure.
Form: Suboxone strips are thin, orange, and rectangular. It has a logo printed on each strip showing the given strengths.
The absorption of the strips involves bypassing the first-pass metabolism in the small intestine and liver, which facilitates fast absorption. Some doses also exhibit higher relative bioavailability.
Taste: Suboxone strips also have an unpleasant bitter taste that may be stronger than the pills.
Storage: Patients should store Suboxone strips below 77°F, and strips should remain in their individual sachets till use.
It is also important to protect them from moisture. This is because the films can degrade due to their sensitivity to moisture, subsequently impacting effectiveness.
Availability: With the discontinuation of pills, the Suboxone strips are now easier to access. The distribution of strips was favored due to their relatively more child-proof quality. The strips are available in 48.3% of pharmacies in the US.
How To Take Suboxone Pills
Patients should take Suboxone pills in a way that follows a suitable maintenance treatment plan. This means:
- Before considering the pills, patients should consult a primary healthcare provider to prescribe the medication and monitor dosage and duration
- Progressively adjusting the dosage depending on how the treatment is going
- Setting a maintenance dose
- Continuing treatment until suggested otherwise (there is no duration maximum)
- Using the tablets sublingually and not cutting, chewing, or swallowing the pills whole.
Suboxone Pill Dosage
An effective dose of Suboxone pills should be adjusted progressively in increments of either 2mg/0.5mg or 4mg/1mg of Buprenorphine/Naloxone throughout treatment.
Generally, doses between 4mg/1mg and 24 mg/6mg per day are suitable. However, the recommended target dose is 16mg/4 mg, which has proven to be effective.
Deciding the quantity to prescribe, especially in unsupervised patients, is dependent on their stability.
If there is concern about abusing the medication, the dosage may have to remain at a lower level. It is essential that there is medical supervision when using Suboxone due to its potential for dependence and misuse.
Conclusion
Available as a pill or as a strip, Suboxone is a medication that has undoubtedly played a huge role in combating OUDs.
With this said, it is crucial to emphasize the importance of taking the drug under medical supervision due to vital factors such as dosage, administration, and managing the risk of dependence.
While Suboxone pills served as an effective form of the drug, their discontinuation in 2012 due to concerns surrounding child safety has positioned Suboxone strips to be the primary form of treatment.
The difference in drug effectiveness between the two forms is minor, with only elements such as administration and appearance differing.
Regardless of the form, it is evident that patients need to take Suboxone treatment seriously in order to recover safely and effectively.
References:
- https://www.addictioncenter.com/treatment/medications/suboxone/
- https://www.recoveryohio.org/suboxone/identification/
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/020733s024lbl.pdf
- https://www.medsafe.govt.nz/consumers/cmi/s/suboxone.pdf
- https://www.empr.com/uncategorized/suboxone-tablets-being-discontinued/#:~:text=Reckitt%20Benckiser%20notified%20the%20FDA,buprenorphine%20and%20naloxone%20sublingual%20tablets
- https://www.medsafe.govt.nz/profs/datasheet/s/suboxonewafer.pdf
- https://pubmed.ncbi.nlm.nih.gov/35691255/
