“Black market” Suboxone is Suboxone that is obtained without a prescription from an unauthorized retailer or individual. While many people buying Suboxone in this way are just trying to stop opioid misuse or prevent unpleasant withdrawal, it still exposes them to the legal and health repercussions. Instead of purchasing illegally, it is always best to pursue obtaining a legitimate prescription both for legal and health reasons.

What Is Black Market Suboxone?

“Black market” Suboxone refers to any Suboxone that has been illegally purchased without a prescription.[1] This can mean purchasing “on the street” from an individual or online from an illegitimate retailer.

Why Would Someone Seek Out Black Market Suboxone?

Ideally we would live in a world where everyone had access to Suboxone who needed it for OUD. However, this is understandably not always the cause. We know there are shortages of medical providers that prescribe suboxone, particularly in rural regions.[4] In addition, patients without insurance can have trouble getting the medication paid for. Lastly, some states have “caps” on the number of patients to whom they can prescribe Suboxone at a time, further limiting availability.

Some of the regulations regarding the prescription of buprenorphine were loosened during the COVID-19 pandemic.[5] Increased use of telehealth services was granted, and prescribers were allowed to treat more patients additional training.[5] While this helped to address the problem, we know that there are still real shortages of Suboxone prescribers and real barriers to care for patients seeking legitimate Suboxone prescriptions.

Many people purchasing it on the black market aren’t doing so to get high.[2, 3] Instead, they are doing this as a last resort because they are unable to access appropriate medical care and get a prescription according to the “correct” channels.

Most medical professionals feel that we shouldn’t be penalizing individuals for buying Suboxone illicit, but instead should be focusing on fixing our medical system so that we have adequate access to legal, medically supervised Suboxone for all patients that need it for recovery.

Why Are Black Market Drugs Dangerous?

Beyond the fact that buying black market drugs means you’re self-prescribing, using black market drugs poses a number of other dangers. These include the following:

• Exposing yourself to the risk of criminal charges for illegally purchasing drugs
• Interacting with black market dealers who may be dangerous
• Receiving potentially tainted or inferior quality drugs
• Getting scammed, receiving fake medication, or receiving no medication at all

What Are The Alternatives To Black Market Purchasing of Suboxone?

The alternative to purchasing Suboxone illicit on the black market would be to pursue a legitimate prescription. As discussed above, this can be challenging, but don’t give up! Advocate for yourself if you think Suboxone would be a good choice for you. The best place to start is to reach out to your doctor. If you don’t have one, reach out to your insurance provider to get connected to a primary care doctor or addiction specialist that prescribes Suboxone. And if you need additional help, reach out to us here at Bicycle health to get connected to a Suboxone provider.

The prescription medications Suboxone (buprenorphine/naloxone) and Prozac (fluoxetine) can interact and cause health issues. Never take these two medications together without checking with your doctor first.

While Suboxone and Prozac can cause interactions, the U.S. Food and Drug Administration says doctors should approach the issue with care.[7] In the past, some doctors withheld medications like Suboxone in people taking drugs like Prozac. The FDA says the damages associated with untreated opioid use disorder (OUD) are so high that the benefits of combined medications may outweigh the risks. This is especially true because depression is very common among people with OUD, and it is important to treat both conditions in that case.

What Are Prozac & Suboxone?

Before taking any prescription medication, ensure that you understand why it’s prescribed and how it works. Ask your doctor or pharmacist if you’re unsure.

Here’s what you should know about both Prozac and Suboxone:

Prozac

Fluoxetine (or Prozac) is an antidepressant used to treat a variety of conditions, such as these:[2]

• Depression
• Obsessive-compulsive disorder (OCD)
• Bulimia
• Premenstrual dysphoric disorder (PMDD)
• Panic disorder

Prozac belongs to a group of medications known as selective serotonin reuptake inhibitors (SSRIs). Fluoxetine works by increasing the time that serotonin (a special communicating chemical called a neurotransmitter) stays active in the nerves within your central nervous system.

Suboxone

Suboxone contains two ingredients: buprenorphine and naloxone.[3] When combined, they treat opioid use disorder (OUD).

What Is Serotonin Syndrome?

Serotonin is a neurotransmitter involved with regulating behavior, mood, memory and core body functions. Medications like Prozac work directly on the serotonin system, and sometimes, they cause problems.[8]

High levels of serotonin can cause serotonin syndrome, which can be life-threatening. Experts say the true incidence of serotonin syndrome is unknown, as most cases are mild and easily overlooked. Even serious cases might be attributed to some other cause.[9]

However, it’s important to know what serotonin syndrome looks like, as combining Suboxone and Prozac can lead to increased risks.

Researchers say some opioids can increase serotonin levels.[8] Combining these drugs can lead to a buildup of the hormone, and it can cause difficult clinical signs.

Serotonin syndrome can be mild. Out of 46,000 calls to poison control centers due to SSRIs in 2011, only 11 of those cases resulted in death.[5]

However, just in case, you should understand the side effects of serotonin syndrome so you can call your doctor if symptoms appear.[6]

Signs & Symptoms of Serotonin Syndrome

If you believe you are experiencing serotonin syndrome, you must call your doctor. Seek emergency services immediately if your symptoms are severe.

Signs and symptoms of serotonin syndrome may include the following:

• Agitation
• Anxiety
• Restlessness
• Disorientation
• Sweating
• High body temperature
• Fast heart rate
• Nausea
• Vomiting
• Tremors
• Rigid, jerking or overactive muscles
• Dilated pupils
• Dry mucous membranes
• Flushed skin
• Increased bowel sounds

Doctors treat serotonin syndrome by discontinuing your medications and monitoring you until they improve.[4] With prompt care, your problems should fade. This syndrome is temporary and resolved once you discontinue the medications.

If you have any concerns about your medication interactions, talk with your doctor.

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