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Is Suboxone an Opiate or Opioid?

Suboxone is the brand name for a sublingual strip of 2 medications - Buprenorphine and Naloxone. It is prescribed to ease withdrawal symptoms in patients with opioid use disorder.

Suboxone is a partial opioid agonist, meaning it binds to opioid receptors in the brain and turns them on, although to a slightly lesser extent than a “full” opioid agonist. Suboxone is a synthetic opioid, made in a lab rather than being derived from the opium poppy.

Buprenorphine is one of the best medications used in treating opioid use disorder.

Opiates vs. Opioids: Where Does Suboxone Fall?

Opiates are natural derivatives of the poppy plant, whereas opioids are synthetic (“man-made”) forms that are derived from the plant. For thousands of years, the only opiate medication was opium, derived directly from the opium poppy. In the 19th century, scientists derived morphine from opium, creating the first synthetic "opioid". This medication was widely used to manage pain, but it was also found to be very addictive.

Heroin is another opioid that was eventually developed from morphine. As doctors continued to look for medications with lower addictive potential, more and more forms of opioids were developed including oxycodone, hydrocodone, hydromorphone, etc.[1]

Unfortunately, all opioids have been found to be as addictive as opiates if not sometimes more so. There are no opioid medications currently that do not have potential for addiction and abuse.

Partial opioid agonists are used in substance abuse treatment and may have less (albeit, still some) potential to cause addiction.

  • Most common opiates: These include opium, morphine, heroin, and codeine.
  • Most common opioids: These include hydrocodone, oxycodone, oxymorphone, fentanyl, carfentanil, and methadone, which are all both medical treatments and addictive substances. Other opioids that have less addictive potential include loperamide (Imodium), dextromethorphan (in over-the-counter cough syrups like Robitussin), and meperidine (Demerol).

Is Suboxone an Opiate or Opioid?

Suboxone is the brand name for a combination of buprenorphine and naloxone, which has helped countless people overcome addiction to opioids by managing withdrawal symptoms.

Buprenorphine is the active drug in Suboxone. It binds to the opioid receptors in the brain, easing cravings and withdrawal symptoms that could otherwise trigger relapse or physical pain.

Buprenorphine is considered a synthetic opioid, meaning it is created in a lab.[2] However, it is important to note that buprenorphine is a partial opioid agonist, meaning its effects are not as strong as a full opioid agonist like oxycodone or fentanyl, which is why buprenorphine is used to treat opioid use disorders(OUDs).

Buprenorphine specifically is a synthetic analog of thebaine, an alkaloid compound that is derived from the opium poppy. Thebaine is a Schedule III drug according to the United States Drug Enforcement Administration (DEA). This means there is some risk of psychological or physical dependence in people who are fully opioid-naïve, or who have not regularly taken opioid drugs to develop some physical tolerance.

Why is Suboxone’s Chemistry Important?

Understanding buprenorphine’s chemical structure can help you understand how it works as a Medication for Addiction Treatment (MAT). Although Suboxone contains an opioid, Suboxone is considered a "partial" opioid and therefore has less of an addiction potential that other "full" opioid agonists like heroin or oxycodone.

Suboxone is one of several buprenorphine-containing maintenance medications helping more people stop abusing harmful, addictive opioids and opiates. It helps them to safely withdraw from physical dependence, complete rehabilitation and counseling, and return to living without the use of drugs.

Since buprenorphine is a Schedule III substance, it does require a prescription from a physician. However, the Drug Addiction Treatment Act of 2016 allows many physicians to provide this lifesaving treatment in their offices with a prescription and outpatient oversight. This makes opioid addiction treatment much more accessible for many Americans.

Suboxone is a film strip that is placed under the tongue, so it dissolves into the bloodstream.[3] Your doctor will work with you to find the optimal dose over a few weeks. Many people remain on Suboxone for months, years or even indefinitely, in order to continue recovery.

SOURCES

  1. Opiates or Opioids – What’s the Difference? Alcohol and Drug Policy Commission, Oregon State Government. https://www.oregon.gov/adpc/pages/opiate-opioid.aspx. Accessed January 2022.
  2. Buprenorphine. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK459126/. January 2022. Accessed January 2022.
  3. Buprenorphine Sublingual and Buccal (Opioid Dependence).MedlinePlus. https://medlineplus.gov/druginfo/meds/a605002.html.January 2022. Accessed January 2022.

Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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