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What are opioids?
Opioids are drugs that work in the body the way opium does – they block the body’s ability to feel pain. Some are made directly from opium (for example, morphine and codeine), while others are man-made but similar chemically to opium (for example, the painkillers oxycodone, hydrocodone, and fentanyl, better known by such brand names as OxyContin®, Vicodin®, Percocet®, and Actiq®). Heroin is also an opioid.

What is opioid dependence?
Opioid dependence is the addiction to above stated opioids. It is a treatable medical condition caused by changes in the chemistry o the brain. When you're opioid dependent, the need to satisfy cravings or avoid withdrawal symptoms can be intense and difficult to manage on your own.

What is Bueprenorphine?
Buprenorphine is a medication used for detoxification and maintenance therapy in the treatment of opioid addiction.

How does it work?
It works by blocking withdrawal and craving without producing euphoric effects. It is the only opioid addiction treatment medication that can be prescribed by a physician in an office setting.

What names does it go by?
The brand names Subutex® and Suboxone® are prescription medicines that both contain buprenorphine and treat opioid addiction by preventing symptoms of withdrawal from heroin and other opioids.

What is the difference between the two separate brands?
Subutex® contains only buprenorphine hydrochloride, while Suboxone® contains the additional ingredient naloxone to guard against misuse.
While the safety profile of buprenorphine--a partial opioid agonist--is generally better than full opioid agonists, the risk of central nervous system (CNS) depression still exists and caution must be used, particularly in cases where other CNS depressants are present.





Onset of action

A few seconds

30 minutes

30 to 40 minutes

Duration of action

4 to 6 hours

24 to 36 hours

About 24-48 hours

Route of administration

Injection, snorting, smoking



Frequency of administration

Several times a day

Daily or more frequently as needed

Every day or every other day

Effective dose

Ever increasing

Blocking dose, usually 80 to 120 mg

2 to 32 mg


Increasing tolerance

Tolerance is stable

Tolerance is stable

Euphoric effects

Euphoria for up to 2 hours

No euphoria when stabilized

No euphoria when stabilized

Overdose potential

High and increased

Rare – Potential if mixed with other depressants

Very rare

Overall safety

Potentially lethal

Very safe – Possibly associated with rare cardiac irregularities—Treatment choice in pregnancy

Overall good profile—Suboxone injection will cause serious withdrawal symptoms in dependent persons – Not recommended for use in pregnancy or breastfeeding—Caution with liver disease – Currently under study


Within 3 to 4 hours after last dose

Within 24 hours after last dose

Within 36 to 48 hours after last dose


Recurring cravings

Eliminated with adequate dose

Craving may not be totally eliminated due to ceiling effect

Pregnancy and nursing

Heroin dependence poses grave risks for mother and fetus

Safe during pregnancy

Not indicated, however study underway

Experience of pain and emotions


Normal pain and full range of emotions

Normal pain, but opioid analgesics may not be effective
May need to switch to methadone – Full range of emotions


Constant mood swings



Physical reaction time and intellectual functioning


Reaction time normal Intellectual functioning unimpaired on stable dose

Reaction time presumed to be normal like methadone. FDA cautions driving and operating heavy machinery in the beginning of treatment

HIV & hepatitis C transmission

High rate with needle use and unprotected sex



Immune system for HIV positive persons

Rapid Progression to AIDS

Progression slowed with methadone

Progression presumed same as methadone – Data not available for burprenorphine

Immune/endocrine system functioning


Normalized during treatment

Presumed normal during treatment – Data not available

Stress response


Normalized during treatment

Normalized during treatment

Criminal activity

High level



Personal relationships


Potential for restoration, Improvement with counseling

Potential for restoration, Improvement with counseling


Deteriorating performance, loss of employment

Full functioning

Full functioning

Community impact

Destructive impact; high crime, high death rate, transmission of disease

Contributes to public health safety, low mortality, increased health

Contributes to public health safety, low mortality, increased health

Additional Sources:
*Both the World Health Organization (WHO) and the National Institute on Drug Abuse (NIDA) have defined dependence on opioids as “a long-term brain disease.