Patients are abusing Suboxone (buprenorphine/naloxone) tabs.
Some people get Suboxone on the street to treat withdrawal symptoms when they can't use their preferred opioid. For example, they'll use heroin on weekends and Suboxone during the week.
Recreational users take it intermittently just to get a buzz.
Suboxone was supposed to be "abuse proof"...because naloxone helps block opioid effects if abusers try to INJECT it.
But people can still get a fast onset and bypass most of naloxone's effect by crushing and SNORTING the tabs.
Plus users are catching on that Suboxone isn't picked up by routine opioid urine drug screens...and it's safer in an overdose.
To curb abuse, consider whether it would be appropriate to switch from Suboxone tablets to the film.
The film can't be snorted and it now comes in four strengths... 2, 4, 8, and 12 mg.
Tell patients they might notice a slight difference. The 8 and 12 mg films produce slightly higher drug levels than the tabs.
Watch for possible abuse...frequent requests for early refills, Rxs from multiple prescribers, etc. If you have concerns, check with your state's prescription drug monitoring program.
www.cesar.umd.edu/cesar/pubs/20110915%20Buprenorphine%20CESAR%20FAX.pdf (9-20-12). http://buprenorphine.samhsa. gov/Buprenorphine_FinalReport_12.6.06.pdf (9-20-12). J Addict Dis 2012;31:1.
- Commentary: Suboxone (Buprenorphine/Naloxone) Abuse