Reckitt-Benckiser to Stop Manufacturing Suboxone Tablets

This week, officials of Reckitt-Benckiser, the pharmaceutical company that manufactures Suboxone and Subutex, announced its plan to stop manufacturing Suboxone tablets. The drug company says the tablets will be phased out over the next six months. According to their press releases, the company decided to discontinue manufacture of Suboxone tablets, “Because of strong evidence that the tablet form of Suboxone is linked to significantly higher rates of pediatric exposure as compared with…the film.”

Reckitt Benckiser says they are basing their action on data from the Poison Control center from September that showed there were around 8 times as many accidental Suboxone exposures in children with tablets versus films. They say they are taking action in the interest of public health.

The drug company says that since the films and tablets are clinically interchangeable, patients presently taking tablets won’t be adversely affected.

In the most recent issue of Alcohol and Drug Abuse Weekly, a spokesman for the company said per 10,000 Suboxone patients, there were .71 pediatric exposures to the film and 6.25 pediatric exposures to the tablets. These numbers were statistically significant. (1)

I believe their data. It makes sense that children would have a harder time opening one of those foil packets of Suboxone film than opening a prescription bottle of tablets. Plus, with a bottle there’s more than one dose available for ingestion, while one packet yields only one potential dose. The tablets also have an orange-y smell and taste, and may be more appealing to young children than other types of pills.

I also think Reckitt Benckiser’s film is a better product than their tablet. Most of my patients do prefer the film, saying it dissolves faster and tastes better.

However…maybe I’m too cynical when it comes to drug companies, but I don’t believe pediatric exposure is the only reason the drug company is ceasing manufacture of the tablets. I think it’s also a financial decision. The film’s patent doesn’t expire for more than ten more years, while the tablet’s patent has already expired. The Reckitt Benckiser rep for my area told me months ago that the company was considering taking the tablets off the market.

I think the recent data about pediatric overdose with tablets gave RB a great excuse to pull their tablets off the market, “For the kids…” The drug company would be open to criticism if they pulled the tablets for a purely financial motive, but who could criticize a drug company for trying to prevent the death of children? I do wonder how pediatric overdose rates of Suboxone tablets compares with other prescription opioids, but after scouring the internet can’t find that information.

I wondered how RB’s decision will affect my patients. I’m worried about a small number of my patients who, for whatever reason, didn’t like the films. These patients are all doing great in their recovery, and show no sign of medication diversion. They aren’t “bad” patients trying to scheme a way to misuse medications. Many of them have been in stable recovery, assisted by Suboxone tablets, for more than three years. All tried the film when it was released, and found it lacking. Some patients didn’t like how the films were crumbling, a problem that seems to have resolved over the last six months. I have about twenty-five people in my practice who prefer Suboxone tablets to films.

Today in my office practice I saw three patients of these patients. All of them, by the way, keep their medication locked up and safely away from children. I explained the situation to them, and told them I would like to switch them to the film, because the tablets were going to be phased out over the next six months. Two grudgingly said they would switch but wanted to wait until it was absolutely necessary. The third said he’s prefer to switch to the generic buprenorphine tablets, because he hated the film and didn’t feel like it worked nearly as well.

Overall I don’t like to prescribe generic buprenorphine in the office, because it has higher street value and is easier to misuse. Since the generic buprenorphine has no naloxone in it, it can be injected. I don’t usually prescribe it unless the patient has no insurance, is stable in their recovery with no recent IV drug use, and can’t afford name brand Suboxone. In my area, the generic buprenorphine tablets are less than half the cost of either Suboxone film or tablet. For some patients, being able to buy the cheaper generic has made it possible for them to afford to remain in treatment. Their other option would be to go to the methadone clinic, and many patients prefer treatment in an office setting, obviously.

My patient today has been in recovery for three years. He has a sponsor, goes to 12-step meetings several times per week, has never had a positive drug screen the whole three years, has a stable home, wife, kids, and also finds time to help his aging parents. I’m going to prescribe generic buprenorphine tablets for him.

This won’t be the right answer for all my patients. Some will have to try the Suboxone films again, and I hope that will work for them.

Because of this pediatric overdose information I’m going to ask every patient – on films or tablets – how they store their medication, to make sure it’s safe.

http://www.alcoholismdrugabuseweekly.com/

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67 responses to this post.

  1. Posted by dbc910281927681 on September 30, 2012 at 3:50 pm

    You know, despite what is said, despite what studies have been done, I personally find the efficacy of the strips to be less in *real world use*. I can’t explain why, as it makes little to no sense. As for them stopping tabs, good. The films have a barcode on them. Kill diversion and keep Suboxone around! The last thing we want is a ‘war on Suboxone’. So, whatever it takes to keep it under control.

    Reply

  2. Posted by dbc910281927681 on September 30, 2012 at 4:10 pm

    QUOTE from you: “However…maybe I’m too cynical when it comes to drug companies, but I don’t believe pediatric exposure is the only reason the drug company is ceasing manufacture of the tablets. I think it’s also a financial decision. The film’s patent doesn’t expire for more than ten more years, while the tablet’s patent has already expired. The Reckitt Benckiser rep for my area told me months ago that the company was considering taking the tablets off the market.” — BINGO!! WE HAVE A WINNER! Trust me, while it is a cynical thought, that doesn’t mean it isn’t true.

    Reply

    • Posted by Karen on January 1, 2013 at 5:51 pm

      I agree war on suboxene is coming when people start killing themselves or others because of the addiction it causes. I agree they don’t want to be responsible for deaths when it gets out how it is being sold in the streets as other drugs and its far more dangerous, the whole child risk is a cover!!!!

      Reply

      • Sadly, it is being sold in the streets. It’s rare that I have a new patient who has not “sampled” this medication already. But most of the studies done on black market suboxone show it’s being used to treat withdrawal symptoms or because patients can’t afford to enter reat treatment. Rarely is it used to get high. Because it is a partial opioid, it’s not as likely to kill as full opioids. It’s still deadly if it’s mixed with alcohol or benzos, though.

  3. Posted by dbc910281927681 on September 30, 2012 at 4:34 pm

    And btw, not all doctors are like you … having a cautious eye towards the pharmco’s… Many are ‘in bed’ with them. I’ve met those who are, and those who aren’t. Those who are will quickly push whatever the latest and greatest patented pill at you. They are offended if you ask any questions about the medication. This applies *especially* to psychiatric drugs, where illnesses can not be objectively tested for and thus can be over-diagnosed by bad doctors.

    Reply

  4. Posted by dbc910281927681 on September 30, 2012 at 4:40 pm

    I’m sorry, I had one psychiatrist I saw who *was* in bed with the pharmco’s, it was quite clear. As I expressed my concern that after a mere few minutes, and me stating I wanting no meds, she dumped a bag of samples in my lap and said nothing more about what the meds did, or their intent. She also called me arrogant and conceited, despite not knowing me for 10 minutes even. Quite directly she called me these things. After getting this bag of drugs after saying I wanted no drugs, I asked her about drug patents, etc.. she tells me I am paranoid, gets very rude. I read a clause in the drug pamphlet, as she tells me “I can read that later at home’.. about how they have no idea how the medication has efficacy (most modern psychoactive drugs say this). They have theories, but don’t know for sure how the medication has efficacy. They can say it increases or decreases this or that neurotransmitter, but can’t say why this helps. REALLY! Read the medication pamphlet, all that small print, it is in the Pharmacology section.

    So, I left this woman’s office, going in because I’m drowning in debt from 10 years ago, don’t know what to do, trying to survive, and worried that my heart may not make it much longer (physically). My dad died only a few years older than me and he took care of himself. This woman didn’t even listen to what I said, later saying my Mom did a disservice divorcing my dad. I dunno who or what her issue was, but man… she even brought politics in, as when I mentioned the patents, she fought back with the ‘FDA is a big part of the problem’.

    Reply

    • Posted by dbc910281927681 on September 30, 2012 at 4:42 pm

      Oh, and I asked her, “How many mistakes have the drug companies made over the years?” .. She says “NONE”… Man, I left there feeling crazy. Please excuse my grammar above, I just woke up, forgot to finish sentences and have no Edit button ;p.

      Reply

  5. Posted by Hysterica on October 3, 2012 at 1:22 pm

    Financial reasons was my first thought as to why they would discontinue it. Children only get into Suboxone pills? what about other pills? Sounds totally unjust to me. How many other opiate-based medications come in pill form? Many. Why the focus on Suboxone? $$$$$$$$

    Reply

  6. Posted by Dave M> on October 3, 2012 at 8:48 pm

    Good Job on discussing the risks of child exposure to tablets! It reminds me to bring up the issue to new patients.

    I would recommend you plant the idea of switching your patients but not switch them yet. Quite often, there is a long lag between the time a manufacturer stops making the product and when the product disappears from pharmacy shelves. Some patients might feel resentful they had to switch prematurely.

    I’m certain R-B is only looking out for the welfare of America’s children and this product discontinue has nothing to do with financial gain (chuckle, chortle)! By accident I have kept a short history of the prices of 30 count bottles of Suboxone by putting the reorder stickers on the wall of the pharmacy. Here is the history:

    1/2008___ $177.50
    10/2008___$181.00
    01/2009___$192.50
    06/2009___$211.25
    04/2010___$226.25
    02/2011___$248.88
    09/2012___$315.00

    One of the worst cases of drug price inflation I’ve seen in a while. Correct me if I’m wrong, but the pill form of Suboxone was brought to market with government aid from the NIH, furthering my belief that R-B is trying to milk as much profit out of this product as possible and their humane reasons are a sham.

    ok, rant over, Please keep up the good work on your blog!

    Reply

    • Wow! That’s outrageous. Yes, RB did have aid from the NIH.
      Information like this that you’ve provided certainly undermines their credibility when they voice concerns for patient welfare.
      No wonder so many people are asking for the generic.

      Reply

    • She is exactly right! Called Walgreens to get their price for generic bupronorphene last week and it has raised to 742$ the generic that I was paying $380 for last year :(

      Reply

  7. Posted by Benjamin K. Phelps on October 5, 2012 at 12:01 am

    Not totally off-topic here, but a little – I wonder if you (Dr. Burson) might give a quick comment on this, as I noticed this same thing (as the last post you replied to) happened w/Lunesta when it was released to the market in ’05. I was put on it by my MMT clinic doctor, & kept on it b/c methadone causes me severe sleep issues (as does any opioid,) & since that time, the price has gone up, up, up, & further up! It used to be retailed at 30 (3mg) tabs for around maybe $150 or SLIGHTLY more… now it retails @ the same strength & dosage for around $225 or so (at the highest cost drug-stores, which were Walgreens in the search I used, & this is using the http://www.freedrugcard.us discount card & pricing engine! I found that card to be about the equivalent of other free cards, including CareMark/NACO county programs – the price was only very slightly less with the latter.) The savings program on their website used to offer the first week free, then $0 co-pay (up to $50 off), & now offers the first week free & as low as $15 co-pay (up to $50 off). Meaning I’m gonna HAVE to pay $15 at least to get a script filled, IF I have insurance. I actually stopped taking it last summer, but it’s gotten even more expensive since then (it wasn’t at $225 or so last summer, in other words… that’s where it currently is, from what I found.) I know Sepracor either sold the drug or was bought out altogether by Sunovion, the current company that markets the drug. But that actually made no difference in price when it first happened. Do you have any knowledge of why they do this (I mean, other than greed, I guess?) Or is it just greed, plain & simple? I was wondering if maybe they intentionally put it out at a cheaper price, get people on it, & then jack prices up, knowing a drug like this can cause dependency? That would be a cynical viewpoint, as well, obviously… but not entirely unfounded, as Purdue Pharma was convicted of pushing Oxy-Contin under false pretenses, claiming less addiction liability (as did Sepracor w/Lunesta, as opposed to other z-class sleep aids, which turned out not to be true, either… Severe withdrawals of the vomiting, rebound insomnia [obviously] & racing heartbeat-type are completely well-known, I found, in other countries w/the racemic zopiclone drug molecule, available since the 80’s outside the US as Imovane & several other brand names. A Google search of zopiclone withdrawal will yield MANY results of people blogging warnings about their experiences. Yet it was marketed here as the eszopiclone isomer in approximately equivalent dosages (just under half the racemic dose, as expected) & TV commercials claimed long-term use was supported w/almost negligible risk of dependency by studies if you & your doctor agreed it was appropriate in your case.) Maybe I should even ask that last question of a doctor in a public forum, so I understand if you don’t want to say they purposely do it – but my doc & I were both rather taken in by those claims, & in good faith I used it long-term… much to my eventual regret! I had to taper over a rather long several weeks from just 3mg, & I’m not one of those people that is really sensitive to the mental side of withdrawals in most circumstances – I handled a 10mg drop twice a week in methadone dose from 155mg/day to 55mg/day w/out ANY problem or complaint whatsoever. Anyway, just thought I’d ask about this practice. Thanks!

    Reply

    • I get a twitch in my eyelid everytime I see that commercial for LUnesta with the green butterfly flitting over the sleeper’s head. Yes, those “Z” type drugs (Ambien, Sonata, and Lunesta – all their generic names start with a “z”) are controlled substances, yet drug reps represent them – falsely, in my opinion – them as being safe with negligible risk of addiction. Not true. I’ve seen many people have difficult addictions to Ambien. I haven’t seen as much with the other two, probably because I don’t think they’re prescribed as much.

      I become ever more cynical about drug companies.

      Reply

      • Posted by Benjamin K. Phelps on October 5, 2012 at 3:26 am

        Thanks for your thoughts on that. I have been seeing more & more problems w/Lunesta since I went through my difficulty, & have LONG known of problems w/Ambien abuse or dependency, as it has been out quite a bit longer. Sonata was way too fast-acting (both the onset & duration) for me, & that seems to almost always be a bigger problem for addiction cases. I did not stay on it long – this was just prior to the release of Lunesta to the pharmacies in May ’05… I think I may have been on it for about 4 months, max. Anyway, I appreciate your thoughts!

      • Posted by crystal on November 20, 2012 at 3:16 pm

        I HAVE BEEN TAKING SUBOXONE FOUR SEVEN YEARS AND I WILL NOT TAKE THAT FILM,BECAUSE THEY R SIDEAFFECTS BAD TO IT.TRIED THEM BOTH AND I DONT WANT TO GO TO METHDONE SO IT HASNT HURT ME I AM DOING VERE VERY VERY GOOD ON MY SUXBONE.

  8. Posted by K. Whitaker on October 15, 2012 at 8:11 pm

    Too bad they don’t include that most of these drug overdoses from children are from parents who buy suboxone on the street and then keep them in things like ziploc bags and altoid cans. Really us a shame for the people who take suboxone legally.

    I personally am scared to try the films. I’ve heard from several people who switched to the films that they had to up their dosage due to not feeling good at night. I’m at 6.5mg. I was at 8 and am slowly tapering down. I want to get off suboxone but at my own pace. Fortunately I have a wonderful doctor. And I have TRICARE so I don’t pay for the suboxone. But I’m scared about being forced to take the films :( Any advice?

    Thanks for this blog. I’ve been reading for a few months. And I have learned a lot.

    Also, I love that you made a post about Suboxone TalkZone. I love Dr Juniig’s blog and the forum is a wonderful resource and support for me.

    Reply

    • Posted by K. Whitaker on October 15, 2012 at 8:12 pm

      *Dr. Junig

      Reply

      • Posted by crystal on November 20, 2012 at 3:18 pm

        i have tried the film and it doesnt do nothing like the suxbone,WE ALWAYS KEEP OUR MEDS A WAY FROM OUR KIDS,THIS IS CRAXY

    • I’d advise you to try to keep a positive attitude toward the film. Most patients do like them better then the tablets. And if you have problems with them, I’d recommend talking with your doctor to see what she says.

      Reply

      • Posted by Benjamin K. Phelps on October 17, 2012 at 1:23 am

        Dr Burson, I would just like to say that I was touched to read on the Suboxone website (R-B’s site for it) that they are “concerned” with patients’ preference of taste and such inasmuch as it may “improve their daily treatment experience!” Lol in a BIG way! It may indeed improve their daily tx experience; but we all know that ain’t why they are pushing the film. But aside from that – my last clinic was using the white Mallinckrodt methadone dispersible tabs when I was there (they’ve since switched to liquid for “diversion concerns,” though they’ve always acted suspicious of ALL patients in every way, shape, and form, no matter how long compliant w/tx…) Anyway, I once wrote the owner (an RN, who has now passed,) and asked if we could switch to the Mallinckrodt generic orange-flavor tabs for flavor reasons – the Methadose white tabs tasted like chalk mixed with Tang, which got really old, really fast, as you’d imagine. I was told that “it’s medicine… it’s not supposed to taste good. And if it ain’t broke, don’t fix it.” She also cited that the white tabs were sugar and dye-free, though the orange has no sugar in it either, and as far as dye – well, the cherry liquid isn’t dye-free either, now is it? So my point here was this: although this was her attitude and not indicative of every treatment provider, I’ve not known of any manufacturers nor providers that were all that concerned with whether we liked or detested the flavor, whether we preferred one over the other in formulation, nor any of those things in methadone treatment. It’s “you take what we give you and you say ‘thank you’ or you can go without your dose, basically. My current clinic does engage in dose withholding for issues OTHER THAN safety concerns (coming in intoxicated on other substances,) which I personally believe is cruel and wrong in EVERY way possible. Do you have any thoughts on this topic (patients’ preferences in dosage form?) I understand it may not be feasible to offer multiple dose forms at some clinics (though some do!) But I could understand and even support the idea that if one is more expensive, offer but add an additional charge (i.e. – liquid versus tabs, the latter costing $1 more a day or something if you opt for it.) I also understand and support not giving tabs until a patient is stable and compliant for a substantial amount of time – you do want to at least make a good-faith effort to prevent diversion when possible. It may be somewhat off-topic for this thread, but R-B’s “reasons” for switching formulations, though we all know the REAL reason(s), just made me recall that issue and wonder someone else’s thoughts that’s on the provider side of this issue. Most of the time, in my experiences, the docs at the clinic didn’t chose which dose form was used at their clinic – it was chosen by someone when the clinic opened, and never changed through several docs. Is it important that a person at least find their daily medicine halfway ingest-able in your opinion? I found myself about to upchuck on MANY mornings (literally!! and actually heaved a few times over the 6 years I took them) when I was at my low-end of the dose curve upon taking that chalk-Tang mixture. I found that taking broken diskets (as 10mg quarters) as though they were tablets was much preferred over mixing it with anything… and believe me, I tried everything under the sun as a diluent. It has always seemed to me that (in the line of saying children are ODing on a particular medication and it’s “unsafe” at some level) children are less likely to grab up the 40mg horse-discs that are methadone and swallow those as they are the cherry liquid, which appears to them to be candy or Kool-Aid, though they should never actually be able to get hold of it. So I’m not sure that the liquid is always preferable in terms of safety. Also there’s the factor of adult ODs, where an adult is less likely (I would think) to take more than 1 of those huge pills as they would be if it were smaller pills and/or to take more than 4/5 (40mg) of a teaspoon of the liquid, which has the appearance of being a small dose, when in reality it’s dangerous beyond that amount for a non-tolerant user, and possibly even in that amount. Your thoughts? Anyone else have thoughts on this?

      • I don’t know about the relative costs of each, but I know stocking more than one kind of methadone makes keeping track of it and meeting DEA standards a little more complicated. All forms of methadone have the same effect (I know some patients will argue that) and more patients prefer the cherry-flavored liquid. Plus, the disks have a higher street value, which indicated it’s more preferred by addicts looking to misuse the medication. And misuse of methadone is so very dangerous.
        The liquid can be diluted and stretched farther by patients looking to sell their dose, and so the feeling from addicts buying it on the street is that they don’t know exactly how much they are getting – possible much less than on the label – with the liquid. Most of the methadone diverted to the black market is in the form of 5 and 10mg pills anyway. that’s from pain patients, not methadone clinic patients

  9. Posted by Benjamin K. Phelps on October 18, 2012 at 9:56 am

    Dr. Burson, in case you don’t know about this (you very well may…), I ran into this on the web tonight: http://www.bdsi.com/Other_BEMA_Products.aspx. It’s a generic that’s about to be submitted at the start of the year (if all goes according to what they’re saying it will) for Suboxone. It will be a buccal film, from what I believe I saw (if I read correctly,) and WILL include the naloxone, so docs that don’t like to prescribe the buprenorphine-only tablets will have an option for their patients and for patients that are not as reliably compliant with their medicines and aren’t as trusted by the docs that do use bupe-only (Roxane generic tabs, I mean) for home prescribing in some cases. I hope this information offers hope to your patients that aren’t able to easily afford treatment with name brand (R-B) products. I know when I was faced with not being allowed by probation to be on methadone but could be on Suboxone (it never ended up happening, as the court did away with the drug court requirement and allowed me to return to my methadone treatment, which had worked for the previous 8 years at that point – the charges were old I was facing…), the cost was my biggest concern/fear – I knew I wouldn’t be able to afford 24 or 32mg/day, and I’ve always needed more than 60mg of methadone. Anyway, again, I hope this offers some of your patients (and blog readers) hope. Please spread the word if you feel it’s appropriate!

    Reply

    • Thanks for the information! this is exciting news. Your link says it will be submitted to the FDA hopefully in early 2013. Can’t come quick enough for me!

      Reply

      • Posted by Benjamin K. Phelps on October 19, 2012 at 3:59 am

        You’re certainly welcome, Dr Burson. While I don’t take it (as you know I take methadone,) I do keep watch over all things “medical assisted treatment”, so I’ve been looking up generic Suboxone or generic buprenorphine/naloxone on Google since 2009, when Roxane first put out their version of Subutex. I didn’t find it that way, oddly enough – I was researching another medication I’d read was about to be released as a generic, & I happened onto the website for BDSI Pharmaceuticals b/c I was interested in reading more about BEMA technology, as it’s used in another medicine I was also reading about. That’s when I looked at their pipeline & noticed it. Funny… But I don’t know how long they’ve had that page there, so I’m not sure why I never got it on Google. Anyway, I’m just happy that yet another opioid dependency medication is about to be brought (hopefully) to the market, even if it is just a cheaper version of a current med. We need all the options we can get! BUT… not at the expense of the ones we already have that are more effective overall. In Illinois at this very moment (from what I’m told,) they’re trying to do away with MMT COMPLETELY, in favor of “safer options that are available” (obviously referring to Suboxone, though it doesn’t state that in the language) b/c of the OD deaths in the last decade – there’s a bill out right now, posted on the AT Watchdog site in its entirety, best I can tell, & this sets a SCARY AS HELL precedent if it passes (sorry for my French, but it is scares me to death!) Other states will follow if it does, particularly conservative ones, no doubt. Not trying to make it a political topic, but just saying many conservatives are of the mindset, it would seem, that “junkies just deserve what they get – it’s not our problem to fix it” or even to offer help to those that pay themselves if it involves anything other than the person saying “totally drug-free” or “abstinence-based.” It’s been said that the medical board of some kind (maybe the Illinois state medical board?? I didn’t go look to write this…) has already approved this bill, though I’m not 100% positive of the age of the bill, its accuracy on the Watchdog board, nor who has supported it, if anyone, at this point. But the original poster of the thread is a loyal MMT advocate & board moderator on the website, so I trust the person’s diligence in making sure it’s accurate before posting it. I cannot understand why simply bureaucrats are able to step into a medical issue such as this beyond perhaps making VERY limited laws about things that might affect public safety – but not withdrawing the whole dang drug off the market in that state for the treatment of our disease!! That’s like a board of non-doctor bureaucrats deciding they should ban cancer treatment chemotherapy in that state because not everyone goes into remission and lives, plus it’s got bad side effects and there’s other treatment options out there. They don’t have enough education, knowledge about, or experience with these medicines to be trying to determine which ones are effective enough to use, and especially not to the point of stating something is SO effective that all other current options (studied more than any other drug therapy in the last 50 years in this country, from the reading I’ve done – Mark Parrino says this) must be done away with in favor of this much newer, somewhat unproven in many ways, treatment. We don’t have studies to indicated yet the effects of long-term bupe use on the liver & body that I know of, compared to methadone, nor protocols for withdrawal (heck, there’s not even been a way to taper anyone until now with the film, since cutting pills beyond quarters is HIGHLY unreliable for getting an exact dosage each day.) There are many questions that have not been answered yet about that treatment, though it’s THOUGHT/PRESUMED to be completely safe, at least as much so as methadone in terms of pregnancy and long-term use for maintenance, and safer in terms of abuse potential (though I know MANY more people abusing that than methadone, b/c it’s so much easier to find! I can’t tell you how many people I’ve worked with at various places that at some point in time ended up telling or showing me that they had Suboxone tablets to get high with on them at work or just in general. And those people know NOTHING about using it safely or when it’s contraindicated due to other drug/mediation use. Many an addict has gotten sick from using it while dependent on full agonist opioids such as heroin or oxycodone.
        Dr. Burson, do you think they’ll succeed with such a bill? I know it’s difficult to know for sure, but do you think they COULD come up with enough support between all the agencies that might have to approve it? That’s what I don’t know – just who would have to give their “OK” for it to happen. I’m wondering if SAMHSA would have any say at all?? To be sure, they wouldn’t support it!! Or what about NIDA, the ONDCP, or NIH, all of whom endorse MMT to the best of my knowledge? It seems some state and its bureaucrats have to try this at least once every 3-4 years or some variation thereof – a moratorium on clinics, preventing patients from driving or bringing kids with them to dose, the use of tablets, the length of treatment allowed… ALWAYS something with them. It keeps those of us on MMT CONSTANTLY afraid, and that’s NOT RIGHT NOR FAIR to us!! We’re constantly stressed that the medicine that’s saved our entire lives from being taken either by death, prison, or constant inpatient treatment, if not health issues from infections and the likes, may be taken away from us before we’re ready – and some of us may never have stability with our endogenous opioid system without medication. I don’t understand why they are allowed to constantly pick on us, again and again and again. This should really be covered by federal law – can’t this be discrimination under the ADA against those that require methadone specifically to stay well? Sorry I typed this much – I get going about my concerns or a topic that interests me and it’s difficult to stop much of the time.

  10. Posted by Benjamin K. Phelps on October 18, 2012 at 9:59 am

    Sorry, it will be a BEMA technology strip that’s applied to the inner cheek, as this company has used with other medications already (i.e. Onsolis fentanyl, etc.) But anyway, it’s pretty much supposed to be about the same as the sublingual film from what I gather in its efficacy and how it works (absorbing through the mucosal membranes.)

    Reply

    • Posted by crystal on November 22, 2012 at 12:34 am

      NO IT IS VERY DIFFERENT THEN THE FILM,BECAUSE I BROKE OUT,MY LEGGS WENT OUT FROM UNDER ME,AND RASHES THEY HAD TO PUT ME BACK ON THE PILL.THATS HOW THEY R DIFFRENT SOME PEOPLE HAVE SEIZURES HAD TO GO BACK ON THE PILL ALSO THE COST IS CHEAPER ON THE FILM

      Reply

      • Posted by Benjamin K. Phelps on November 23, 2012 at 10:00 am

        @Crystal – What I meant was that the drug efficacy & how well it works is supposed to be equivalent to the tabs… NOT that the film & its inactive ingredients (which interfere in many various ways in EVERY tablet, film, liquid, suspension, & so on) will work the exact same as the tablet. Every time you switch from one brand or form to another, you are changing in some way (sometimes only minutely; sometimes completely different) the ingredients, which changes how fast the medication is absorbed by your system, how long it may stay in effect (it’s not going to change the half-life of the drug itself, but it may dissolve slower, causing the drug to not clear your system for the same length of time longer – i.e., it takes 10 minutes longer for a pill to dissolve, so it takes around 10 minutes longer for it to clear your system [though you'd be highly unlikely to notice this difference,] in a perfect hypothetical situation), & almost every other variable you can think of. Peoples’ digestive systems have varying amounts of digestive acids, work at varying speeds compared to others’, & peoples’ body systems (brain, organs, etc) react differently to drugs than other folks’ systems do. Finally, people also have different metabolisms among them. All these things & more come into play here. So please don’t think (along w/others reading this) that I’m saying that everyone who claims they didn’t react well or react the same to the film than they did the tabs is a liar or is imagining it, nor am I saying you don’t know what you’re talking about. They just removed Budeprion SR300 (an off-brand name for the reference-listed Wellbutrin SR300 brand name, which is generically called bupropion) from the market (but not the 150mg version of the same brand/manufacturer as of when I read the article @ the beginning of this month) from the market b/c it was found after quite some time to NOT react the same way as the brand name or other generics of the same medicine do & thus, people had been reporting for as long as it’s been out that they were falling deeply back into depression. They were also having really bad temper fits & just all kinds of problems that were basically ruining their lives! However, for all the time it was on the market, people weren’t taking these patients seriously, dismissing their complaints as anecdotal &/or the so-called placebo effect (thinking their pills weren’t as good b/c they were generics; many people think that way…) I’ve experienced this particular problem w/a single medicine back in the 1990’s, & others told me that they had experienced the same issue w/that same drug – oddly, w/out me having mentioned my thoughts on it to them first! So no, I don’t dispute your feelings about this, nor anyone else’s. Oh, & incidentally, the reason the FDA didn’t know about the Budeprion problem is that they don’t typically test all strengths of a medication when it’s formulated the same according to the manufacturer – they extrapolate the data on how quickly the medicine dissolves & other factors from the single strength that they do test. So in this case, they tested the 150mg tab @ the manufacturer & sent the data on that, along w/the extrapolated data from it for the 300mg tab. As it turned out though, they were not the same – unless we find out down the road that people are still complaining about that 1 as well. Thus far, they’ve summed up the complaints & found them not to apply to the lower dose… just FYI.

  11. Would RB be able to use the sealed foil packet, with it’s serial number and just place the pill form of the drug in the sealed foil packet ? This would also make it as difficult for a child to open the pill form?? I would like to think the best of everyone, but thier “concern” seems too convienient with the timing of the expiration of thier patent?? I hope with the patents expiration that more people can afford treatment. While I do think that it is good to make it as difficult as possible for a child to open the medication , I think that it is a much better idea to educate patients and make sure that Children have NO access to the medication. I know that mistakes happen, but this type of m,edication should be kept far out of reach.

    Reply

  12. Posted by Cathy on November 12, 2012 at 8:51 pm

    I am currently on Methadone for long term pain management, not addiction. Because of the osteoporosis the long-term effects are having on me, my doctor wants to put me on Suboxone. I am on medicare. Ha, it will cost$600 a month without insurance. This is outrageous. Why the greed? Why is it so necessary to be soooo greedy??? I am sure you can do better on your pricing structure for these types of meds. I also understand that the films are more expensive than pills to mfg. Yet more money in your pocket……? This assures that I will not be able to take the medicine at all. Who is that helping?

    Reply

    • If you have chronic pain but no addiction, you can be prescribed any number of opioids. If you can’t afford Suboxone, let your doctor know. It’s only addiction that can only be treated with the two medications methadone and buprenorphine, better known as suboxone or subutex. Patients with pain aren’t limited to these two opioids, because without addiction, presumably you are able to take your medications as prescribed and don’t take extra/run out early.

      As far as the pricing structure, you’d be better off to ask the manufacturer these questions. Doctors don’t set prices for medications. Pharmacies and pharmaceutical companies do that.

      Reply

  13. Posted by MKM on January 1, 2013 at 12:37 pm

    I was on the tablets around 2009, tapered down slowly and was able to be off subox for over two years. I’ve slipped up over the course of the last six months and unfortunately went back to a Dr to get help. The Dr. gave me the strips which I was excited about since it was something new. In my personal experience I don’t feel as though they work as well. I’ve had several strips that were cracked & brittle & I’ve informed my Dr about this and asked to go onto the pills. He has informed me that he’s never had anyone complain about the strips condition or quality/strength & he couldn’t put me on the tablets because they are no longer producing them (after Jan 1st according to Dr)

    I highly doubt big pharma has phased out the pills simply because they care about the safety & well being of children.

    Without insurance this medication is expensive, and to have to take something that I feel doesn’t work ( as well ) for me is very frustrating.

    I could be wrong, but the only reason I feel they are phasing out the pills, is to secure their market in being the lone soldier producing this medicine.

    Reply

    • Posted by MKM on January 1, 2013 at 12:45 pm

      “the most recent issue of Alcohol and Drug Abuse Weekly, a spokesman for the company said per 10,000 Suboxone patients, there were .71 pediatric exposures to the film and 6.25 pediatric exposures to the tablets. These numbers were statistically significant. (1)y other pharmaceutical company”

      This maybe the most idiotic thing I’ve ever read, So a few bad apples ruin something for THOUSANDS of people.

      Reply

    • yep i think i agree with you.

      Reply

  14. Posted by MKM on January 1, 2013 at 1:38 pm

    Dr. over the course of your treatment how many patients have you put on Subutex (I know you can’t tell me exact #, but roughly)? I’ve read a lot of forums and I RARELY see any patient who is prescribed Subutex.

    The few people that I do see on the forums that take Subutex say it works great, and it’s cheaper.

    I understand that the risk for abuse is higher since user can still use. However, if a patient asked to be put on the Subutex and agreed to take urine tests and passed how come more people are not allowed to be put onto a medication that has worked for many.

    Reply

    • I don’t use Subutex (the brand marketed by Reckitt Benckiser) but rather buprenorphine, the generic for Subutex. In my office practice, I have 40 or so patients who have been in stable recovery and doing well for more than 4 years, so I feel it’s safe to use it in those patients. Theoretically, it can be injected, so it’s not a good idea to prescirbe it right away in an IV user until there’s time of stability in treatment. Even with the risk of misuse, it’s still so much safer than methadone, that I do prescribe buprenorphine in the opioid treatment programs where I work. It’s still a bit more expensive, though.

      Reply

  15. Posted by Karen on January 1, 2013 at 5:43 pm

    I would like to ask you a question: where can i find information such as medical research published that relates to the tampering down and the withdrawal symptoms when people quit suboxone ?
    I even after tampering down to 0.5/day for weeks feel like I wanna die. I was closed to commit suicide yesterday. I fell like I am in Hell and the depression is unbearable. All I did was change my addiction to a drug that is 100 times more addictived and dangerous than other opiods. How can u live with yourself knowing what you are doing? all this is a scam that about making money when people pay $ 750 first visit plus 375 prescription and aftre that each visit costs $140.00 /month plus 3
    $370.00 or more per month refill. PEOPLE BEFORE U GET ADDICTED TO THIS DRUG READ INFORMATION ABOUT HOW YOU WILL GET OFF OF IT, U COULD DIE AS THE THE DEPRESSION IT CAUSES IS REMARKABLE!

    Reply

    • *Sigh* Here we go again.
      It’s not “100 times more addictive.” And for most patients it’s the safest opioid, because it’s only a partial opioid and not a full opioid. Patients in suboxone treatment (not buying illicitly off the street) have lower death rates than patients with untreated opioid addiction.
      However, I hear what you are saying about withdrawal symptoms. It’s probably genetic, but some patients have little if any withdrawal, and other patients have terrible withdrawal. Sadly, it sounds like your withdrawal is one of the worst. Overall, most people do have withdrawal if they stop the medication suddenly.
      The best results are seen when patients stay on Suboxone. The theory is that during your opioid addiction, your body stopped making its own opioids, and without the Suboxone giving you what your body should be making on its own, you feel very bad.
      When patients are ready to taper (have had extensive counseling, no other illicit drug use, no physical or mental health problems, relatively low life stress) it should be done over 4-6 months. The end of the taper is when you need to drop more slowly, because even a small drop in milligrams is a bigger percentage of the whole.
      Please talk to your doctor and slow down your taper.

      Reply

  16. Posted by Karen on January 1, 2013 at 9:58 pm

    I did the tapering slowly very slowly, I have no mental problems, I am taking ibuprofen for muscle aches and .5 clonazepam for anxiety , no other drugs involved, drinking a gallon of water a day and still today is day 8th after quitting and I can’t even walk, I’ m very depressed feel desperate of feeling this way. How long is this agony going to last? This is my point, where is the research about quitting this drug.??? has it been studies about it? I am not lying I feel like want to die. I am a scientist as well. I have a biology degree, so I understand the whole physiology of the brain receptors. Please help me! what can I do to start feeling better? what is the average suffering time after quitting? where can I find info so I have hope that this torture will end. Please help me :-(

    Reply

    • When Suboxone first came out, everyone thought great, here’s a partial opioid, not as heavy as methadone, that we can use for a few weeks, taper people off of it and they’ll be fine. Sadly, that’s not turning out to be the case. As you can see in the relatively recent reference, done specifically on pain pill addicts rather than heroin addicts, if the suboxone is stopped, relapse rates are very very high. So now we think of this medication as a maintenance rather than a short-term medication. http://www.nih.gov/news/health/nov2011/nida-08a.htm

      In other words, this medication shouldn’t be thought of as a short-term thing because it doesn’t work that way. It needs to be taken for months, maybe years.

      It sounds like you were started on this med without being told that some people have a tough time stopping Suboxone, and there’s a high incidence of relapse when it’s stopped. I don’t think anyone can tell you how long the withdrawal will last for you, but overall patients say the worst is over after 2-3 weeks, but then there’s a subacute phase where you feel tired & lousy. No telling how long that can last. sorry it’s not better news. the withdrawal is said usually to be less severe but longer than short-acting, full opioids like oxycodone. But everyone is different.

      I advise going back to your doctor, or call her, and tell her how much problem you are having, and see if she would consider prescribing clonidine, a blood pressure medication that treats some of the withdrawal symptoms. In some patients, it helps a lot. IN others, not so much. consider going to Narcotics Anonymous meetings, where you can meet people who have been through that withdrawal and are now living well, off opioids. Or consider going to an inpatient drug rehab for a month (if you can do this) where you’ll have supportive care and relatively intense counseling to help you stay clean.

      people often mistakenly compare opioid withdrawal to the flu, but those who have been through it know it’s much worse than that in most people. In bad withdrawal, people feel like their bones are being pulled apart, and many have the severe depression that you describe. If you’re at the point of wanting to die…it’s time to get medical help.

      Reply

      • Posted by Karen on January 3, 2013 at 1:06 am

        Thank you! I read the link you suggested and this sentence really got my attention:

        “so, more research is needed to determine how to sustain recovery among patients addicted to opioid medications.”

        Basically, scientist do not know enough of the real results after treatment. How come doctors are not telling their patients that this medication is very strong and that he or she might have to stay on it the rest of their lives because they could die if they stop even after slowly tapering. I followed all the rules and I am really dissapointed.

        I know this medication will be taken out of the market one day when the officials realize the damage that is doing. I will continue my agony…..today is day 10 and I had a bad anxiety attack …Thanks God I have support, people that are watching me 24/7….or I would be dead…. I followed my doctor instructions and the more I suffer the more determined I feel to stay away from this drug…..If I had known it was going to be like this , I would have tapered down from the regular pain killer I was taken before. you say this drug is not more addictive than others because you have not seen people in real life. You should try one strip and the tell me that is not addictive. I heard of people who buys it on the streets because they get higher with suboxone than with other pain killers. My conclusion is THIS MEDICATION IS NOT REALLY HELPING PEOPLE TO GET OFF OF PAIN KILLER ADDICTION . IT IS ONLY MAKING THEM ADDICT TO A NEW DRUG WAY MORE DANGEROUS SINCE THE DEPRESION IT CAUSES WHEN STOPPED COULD MAKE THEM KILL THEMSELVES…..PEOPLE BE AWARE WHAT YOU ARE GETTING INTO….I RECOMMEND NA, A VISIT TO THE COURT EVERY WEEK TO SEE HOW YOU COULD END, AND DETERMINATION TO STAY CLEAN. DO NOT CHANGE AN ADDICTION FOR ANOTHER…..I SPOKE FROM MY HEART….

      • Posted by Benjamin K. Phelps on January 4, 2013 at 10:28 pm

        In response to going to court to see how it could end, blah blah blah… Honey, if that helped, we’d have all been off L-O-N-G ago. So would you. We ALL know what happens at the court house to drug addicts. We all know what drug addicts do for money & drugs. We all know what damage drugs do to our bodies. That has yet to stop us from using them, because it has no bearing on our disease. Drug addiction is a disease – not a lack of will power because we just haven’t seen or heard enough of what bad things they can do. Come on – you of all people should know this by now – you’re an addict! I hope you are able to stay clean when you get off this stuff. But some of us have tried all the other ways besides maintenance and were not able to stop. Give us the respect of not talking smack about our treatment that has saved our lives. It’s FAR from trading one addiction for another – I’ve yet to pawn my possessions for methadone, sell my body for it, shoot it in a vein, skip paying my rent/utilities/bills for it, neglect my loved ones for it………. I did all that for heroin on a regular basis (with the sole exception of selling my body, but that was only b/c I never had to… yet…) I’ve done NA, I’ve done inpatient, I’ve done it ALL & for YEARS & YEARS. I’ve done prison, probation, jail, community service, & everything else you can name. If you want off this medication b/c you feel it didn’t help you, I hope you are able to make that happen. But I am forever grateful to medication-assisted treatment & grateful it’s available to me. If I need to be on it for life, I’ll be okay with that, & I will NEVER see it as trading an addiction for another. I may be dependent, but I’m no longer living as an active addict. Case closed. I wish you the best, Karen. Don’t rant about things you are not educated about other than your own experience, which has now been tainted by your having been tapered too fast. Just b/c some will abuse these meds doesn’t make them evil or any less useful. Just saying.

      • Posted by Benjamin K. Phelps on January 4, 2013 at 10:10 pm

        You know, (referring back to the comments about how horrible withdrawal is from buprenorphine & how some think they can get on & right back off without bad withdrawals…), it is sad that anyone believes they can get on ANY (& I STRESS “ANY”!!!) opioid & have an easy time coming off after months or years of taking it. It’s as if people believe it’s going to be a good time – a party, almost – & then they’ll just mosey on off it & life will be grand. That ain’t how this thing works. Don’t think that I’m trying to sound like a smart-&#%… I’m really not. But opioid maintenance is supposed to be for those that had nothing else work for them, and for extended periods of “maintenance”, not a simple stretch of 8 months or the likes, except in the cases of detox instead of maintenance, in which case the dose was dropped from the very beginning. Being maintained allows the drug to build up in the body, & for the body to adjust to being totally used to (dependent) on a long-acting opioid. It does NOT respond kindly to having that yanked away from it, even at relatively slow intervals! That’s NOT to say you cannot withdraw relatively pain-free if you go slow enough, but with Subutex/Suboxone, there are not any ways to cut the dose at tiny intervals as there are with methadone. It might even be a better idea for those with bad reactions (bad withdrawals that are unbearable) to switch to methadone & be dropped 1mg at a time over a period of weeks/months, rather than trying to break up a 2mg tablet, which cannot be broken reliably into constant sizes that are identifiable. You need to know how much you’re ingesting EVERY DAY so that you can take the same amount each day until it’s time to drop again, and then you can drop a certain amount. Breaking a tablet up (anything other than according to a score-mark on it, which usually only breaks it into half, or at best, quarters) is NOT the way to detox from powerful opioids in our circumstances. We are NOT people that can (or do) tolerate discomfort AT ALL when it comes to this. Dr. Burson is absolutely right – you have to seek out medical help, detox slower, & get support from those that can show you a light at the end of the tunnel. Otherwise, you’re only going to be angry, in pain, depressed, & in a bad way in just about EVERY way until your body can start to heal from what it’s going through. That takes a lot of time, unfortunately, & more for some than others. There is theory that some people may never heal completely from opioid abuse, in which case, opioid maintenance should not be discontinued, as you’d never expect to feel normal after that if the theory holds true. I can’t say either way with any authority as far as from the scientific aspect, but I absolutely CAN tell you that from an anecdotal aspect, I FULLY believe & will to my dying day that my body will NEVER be the same as pre-opioid abuse, & I will likely never be okay without my methadone maintenance. I don’t like that, but it would appear to be the way it is, whether I like it or not. Hence, I am content to remain on medication for as long as I must. My clinic has been doing its level best to run me away from treatment, but thus far, I have resisted. But that’s a whole different issue…

      • Huzzah! Well said.

  17. Posted by Benjamin K. Phelps on January 4, 2013 at 10:19 pm

    Sorry, in case it was unclear, I meant above that it might be more appropriate to be dropped 1mg at a time on methadone than to break down 2mg buprenorphine tablets – I did’t specify what 2mg tabs I was talking about in my comment. Methadone can be (for those that don’t know this) dropped as slowly as 1mg at a time, since it’s in liquid form. Even in tablet form, it can be dropped 2.5mg at a time, which for methadone, is still relatively slow (especially compared to buprenorphine doses.) For buprenorphine, 2mg is a HUGE LEAP!! You need to drop at MUCH slower intervals than 2mg or even close to it (for most people.) Maybe .25mg would be more appropriate for many when it comes to that drug. That doesn’t make it “more addictive” or anything like that – it just means that it’s potent, & they aren’t making enough dosage levels to accommodate the slow taper that patients need – they thought primarily of the maintenance period, & less of the taper period when they came up with the 2 & 8mg tabs. That’s a shame, since people do eventually want to taper much of the time, even when they should perhaps stay on. But no matter – you have to speak to a doc & understand what the options are when it comes to tapering – & switching to methadone to taper is NOT a terrible thing, though I’m not attempting to give medical advice. And contrary to what some might suggest, it would NOT “hook” you on another drug or make things more difficult – it would simply transfer you to the same point on a different long-acting drug of almost the same half-life (there’s a slight difference in time of action of the drugs.) Anyway, the point I’m making is this: if you think moving to methadone would be horrible & unthinkable, consider the fact that either way, you’re still dependent on an opioid & working your way down. Only with methadone, you could work your way down at a MUCH more comfortable rate, & you wouldn’t be forced to jump off from a steep cliff at the very end. Just something to think about & ask your doc about if you’re having a difficult time (for anyone out there.)

    Reply

  18. I like how it is somehow the pill manufacturer’s “fault” that kids are able to get ahold of diverted pills and take them. Seriously? Where is the personal responsibility! Any and ALL medications that are schedule IV and above in the united states should be kept in a locked box in a household with children — it’s just that simple.

    Also I gotta disagree with you re: generic bupe tablets being “IVable” and suboxone tabs aren’t — I’ve IV’d suboxone tabs plenty of times, and so have a lot of other people (google it, there’s tons of experiences out there that have been posted).

    The naloxone really doesn’t have any effect; even in tollerant patients. There’s two reasons for this — one, the most important reason, is that bupe itself has a higher binding affinity than naloxone to the mu receptors — the other is that there simply is not enough naloxone in the tabs to cause any kind of physiological response.

    A one time dose of 2 mg of IV naloxone is not even enough to bring a fairly tolerant person back from an overdose of heroin.

    I often wonder why they even put naloxone in the tabs / film at all — it really makes no sense to me whatsoever. It does *not* prevent IV “misuse” and it perpetuates myths about safety, etc.

    Reply

    • As I just posted in reply to another commenter:

      Studies do show less misuse of the combination product buprenorphine/naloxone than the monoproduct buprenorphine.

      In one survey of opioid users in New Zealand, eighty-one percent of these addicts said they misused the monoproduct, containing only buprenorphine. After the combination buprenorphine/naloxone product was released, 57% of surveyed opioid addicts surveyed reported misuse of this product. Street price of the combination product was lower than the monoproduct, and subjective impressions of addicts were that the combo product was less desirable. One third reported that they had experienced opioid withdrawal after injecting the combination product. [1]

      In a more recent Finnish study, attendees of a needle exchange program were surveyed about their abuse of buprenorphine products. Seventy-five percent said they had used IV buprenorphine to treat addiction or treat withdrawal. Of the 68% who had tried the buprenorphine/naloxone combination product, 80% said they had a bad experience. The street value of the combination product was less than half of the monoproduct containing only buprenorphine, indicating a preference for buprenorphine-alone preparations. [2]

      In preparation for its approval in the U.S., a study was done by Bridge et. al., regarding the safety of the combination product as compared to the monoproduct, and they found a reduced likelihood of intravenous abuse in the combination product compared to the monoproduct.

      I’ve cited a few of the other studies as well. [3,4]

      1. Robinson et. al, “The misuse of buprenorphine and a buprenorphine-naloxone combination in Wellington, New Zealand,” Drug and Alcohol Dependence, 1993, Vol. 33(1), pp. 81-86.
      2. Alho et. al, “Abuse Liability of buprenorphine-naloxone in untreated IV drug users,” Drug and Alcohol Dependence, 2007, April 17;88(1): 75-78.
      3. Mendelson et. al., “Buprenoprhine and naloxone combinations: the effects of three dose ratios in morphine-stabilized, opiate-dependent volunteers,” Psychopharmacology, 1999, Vol 141(1), pp. 37-46.
      4. Fudala et. al, “Effects of buprenorphine and naloxone in morphine-stabilized opioid addicts,” Drug and Alcohol Dependence, 1998, Vol. 50(1), pp.1-8.

      Reply

  19. Posted by Benjamin K. Phelps on January 21, 2013 at 3:34 pm

    Hold your horses there, @NQZ – before you claim it’s ignorance preventing *this* &/or other docs from prescribing Temgesic & such, your ignorance is preventing you from understanding why, no disrespect intended (though it did appear you intended some in your post…) No matter – the reason I say this? Because Temgesic is not available in the US. Besides, I *believe* that the laws about buprenorphine use in addiction medicine were very specific as to the dose form to be used. I.E. – Buprenex sterile liquid for IV injection was available back then & used in the trials (orally), but was never approved for use in addiction medicine. I do not know for certain that docs could not use other forms of bupe (such as Butrans, which is the patch Purdue makes that’s indicated for pain), but I’m thinking & would guess not. Dr Burson, am I wrong about this? I AM certain that there are only 4 controlled medications they can choose from in treating us (that are FDA approved for doing such): LAAM, methadone, & Subutex or Suboxone or their equivalent formulations. And since LAAM (Orlaam) was discontinued in January 2004 by Roxane Pharmaceuticals due to possible QT prolongation (heart issues), that’s not an option any longer. So they’re stuck with only methadone & bupe. When it comes to buprenorphine, as Dr Burson has written MANY times now, the combination formulation has been studied & shown numerous times in numerous places to be abused less than the mono-product. That does not mean they think the combo-product CAN’T be or NEVER is abused by anyone out there, or even that it’s not happening more than just a little bit… But it’s incentive for them to ONLY give the mono-product to patients that have been in treatment & compliant for longer periods of time, rather than just being willing to hand it out to any & everyone that asks for it. I can’t blame them for that one bit! Their license is at stake – this is their WHOLE LIVELIHOOD we’re talking about here! Would you risk YOUR whole career/livelihood on the word of an addict who promises you after 2 months in treatment that s/he won’t abuse an opioid if you will give him or her a month’s worth of single-opioid-entity tablets to take home without any supervision, knowing that 2 months ago, s/he had a needle in his or her arm, injecting any & everything except Ajax & Comet cleanser? Sorry, I can’t say that I would – & if you would, hate to tell you, but you’d be out of a career very quickly. It takes us methadone patients AGES to get takehomes, & yet I still constantly hear of takehomes being sold by patients, or other such indiscretions. Were I a doctor myself, I’m sure I’d want to have Temgesic or the likes as an option to help my patients taper. However, when the DEA or their overseas equivalent has not “OK’d” that SPECIFIC dose form/brand to be used as such, I’d be LIVID of them running up into my office/clinic to seize my medication supply, rummage through my patients’ confidential medical files (& possibly take them “for audit/research purposes”), & shutting me down, thereby leaving every single one of my patients without treatment abruptly! Most of us have heard & read all about such horror stories happening when an overzealous agent or 2 get sent to audit a clinic or doc’s office, & they go haywire up in there, accusing the doctor of frivolous prescribing of unneeded high doses (when they’re realistically reasonable), accusing them of keeping patients in treatment too long (when it’s well known that pushing patients out of treatment only pushes them toward relapse in most cases – best evidence states that docs should willingly assist patients that desire a taper, but not to push a taper on them), making all sorts of other silly & harmful accusations that end up possibly in the newspaper or some other ungodly thing such as that & all but ruining the reputation of that program when it’s done nothing wrong. And you wonder why these “ignorant doctors” won’t rush to prescribe Temgesic & such to patients? And why the mono-formulation isn’t handed out indiscriminately? Their license to practice addiction (or ANY form of) medicine wouldn’t last 2 weeks if they were willing to be that flippant about treating us. I agree with you wholeheartedly that it’s a terrible fact that R-B (who makes Temgesic, as well, btw – so it’s not like they don’t know what a standard regular dose is for the average person, & that type of dose is much more appropriate to step off of than a maintenance dose given to the typical addict!) doesn’t bother to make lower dosages available for tapers. That’s a REALLY poor “oversight” on their part (which we can all agree is EXTREMELY likely to NOT be an oversight at all!) But going about fixing the situation by straying off the legal path is NOT going to be the proper/best way for docs to make this problem known. By now, I’d also agree that this should have been handled AGES ago – bupe was approved for this use in 2001, I believe, & so they’ve now had 12 years to fix this oversight. So why docs haven’t screamed & yelled at R-B over this, I don’t know – or maybe they have – to no avail. Dr Burson might be able to tell us more about that aspect of it. I don’t know if when you said “*this* doctor” in your post, you were referring to Dr Burson (?? – she practices in the US, where Temgesic isn’t even available, so ??), but if so, keep in mind that she does FAR more than most addiction docs practicing to even have a blog where she communicates daily with opioid dependent patients, getting our side of things regularly, & considering our feelings on the issues we correspond about! She & I may not see eye to eye on every single topic that comes up, but I always have to keep in mind that my viewpoint is a little one-sided at times, since I’m in treatment. Hers can be too, I’m sure, as she is a doctor treating folks like us, who’ve lied to her, attempted to con her, & shown her all kinds of bad behaviors, no doubt, during her time treating addicts. And while she has studied addiction & knows what to expect from us, I have no doubt that it gets hard to remain objective about these things when you’re the one being lied to & conned. None of us like to be taken advantage of, when it comes down to it. So just give these docs (some of whom aren’t nice people, I understand & know all too well, btw) the benefit of the doubt in some instances where there’s a chance you don’t know all the facts that are applicable to the situation. And as I just pointed out, there are some that go WAY overboard with their rules & regulations, & some that treat us all as bad people & some that shouldn’t be in the field at all… there’s no doubt about that. But reserve accusing of being ignorant for the ones that show no concern for you when you discuss an issue with him or her, who aren’t even willing to discuss your concerns with you, & who don’t use evidence-based practices in their treatment methods (like the ones that institute arbitrary dose-caps & that use your medicine as a reward & punishment system, refusing to dose you when you don’t jump through hoops for them or do just what they want at the moment [not talking about not dosing for safety concerns such as you presenting for dosing while already high/drunk - that's justified.]) Ultimately, if you have been compliant for an extended period of time (all clean urines, attended all required counseling &/or groups, paid fees as required, etc) & your doctor refuses to work with you in what you feel is a reasonable manner, then at that point it may be a justifiable move to seek out a new/different doctor to treat you. I know that if you want to come off, that seems a moot point. But it’s pretty much about all we have control over in our treatment – & some of us don’t even have the luxury of choosing where we get treatment, so if you have that luxury, don’t take it for granted. I’m on methadone, & I’ve got 2 choices unless I want to drive a long ways out of town to clinics that also charge more than where I currently am. Neither of the 2 in my city are run well, as is well known by the advocacy board on the web (they are familiar with the management of both.) But I either can make the best of it or I can leave treatment & screw myself. Thus, until I can leave this area, I am making the best of it, despite that I feel as though I’ve been trampled all over in every way possible at my current clinic, & I’ve been compliant since the day I walked into the door! Just cut your 2mg tabs into quarters, & then you’ve got .5mg pieces. How much lower would you really need to go? If you did, you could always put in the .5mg piece a short time & spit it back out before it’s all absorbed. That’s not an exact science, of course, but it would at least give you some step-down assistance over jumping directly off. Best wishes to you either way.

    Reply

    • Posted by Dan Lester on February 25, 2013 at 7:17 pm

      i have had that happen with two doctors of mine, all of a sudden the clinic or hospital a=calls and asks how much medicine you have because the doctor was kicked out of the office and they are scrambling to figure out what to do with a hundred patients that are gona start getting sick, bc of this. one doctor i had called to ask to come in early to post date a script bc i was gona be working a job outa town for about a month (independent contractor) and he said, “no dan im sorry i cant help u, ive lost my license to prescribe”. and that was it. there were me and 99 other people all trying out damndest to get into other doctors. and when u called another office and said u were with doc X, they would turn u down. honestly the doctor was caring, but not a straight shooter, that was 7 or 8 yrs ago. ive been on suboxone for almost 9yrs, with a few attempts off of it and ending back up on the streets loseing everything i owned. in the begining suboxone or subutex wasnt that desireable by to many “junkies” in my area, it was shortly after i got on it (couple yrs) that everyone and there mother were trying to get on it. I could sit in my clinic and pick out the patients that obviously diodnt need it, they either got high off it, or paid there bills with it. it disgusts me bc people like that are fucking it up for people that need it. anyway..good post. PEACE

      Reply

  20. Posted by eric michaels on February 6, 2013 at 9:20 pm

    fact is that the film is abused more than tablets, the film shooters love because they can shoot them easily, and they get high, tabs are much more safer, and harder to abuse, just my opinion!

    Reply

    • Posted by Benjamin K. Phelps on February 7, 2013 at 1:20 pm

      I take methadone, not Suboxone, but I have very little doubt you are quite correct, @Eric. But as we all know, this was a financial move for R-B, not a safety 1, like they want the public to believe. When patents are about to expire, it’s a frantic dash to find a way to avoid a loss in revenue, whether that be to begin selling an active-isomer only version of the drug (as was the case w/Prilosec when AstraZenica made Nexium – “the Next Purple Pill”, or when Eli Lilly made Sarafem, a different brand name w/different indications – in other words it is indicated to treat a different disorder/disease – than Prozac, which has the exact same drug in it. It’s just that Sarafem has 1 additional dose level that Prozac doesn’t (the 15mg capsule). There are PLENTY more examples of this – Lexapro, Clarinex, Pristique, on & on. It’s ALL about reaping the rewards of their labor, though I wouldn’t go so far as some people do to actually say there’s a conspiracy going on where the big pharma companies actually try to keep us sick so that we spend w/them. Have there been cover-ups in the past? Sure… to keep from losing millions invested in research & marketing on a drug & then having it all yanked out from under them. And new drugs cost SO much b/c they spend millions to discover them – remember, someone has to also pay for the drugs they tested that did NOT work out in the end. Those studies cost A LOT of money. Then there’s the multi-million dollar advertising for the ones that did work out. But to be fair, they usually offer their meds at very reduced prices or even free if you can show you are truly indigent. That sort of negates the notion that they are JUST about money & keeping people sick. I think if keeping people sick were the deal, there’d have to be WAY too many people in on the scheme for it to work – somebody’d eventually get angry or disgruntled somewhere in the chain & go to the media & the whole country, if not world, would go into an uproar that would make far too many waves for them to try anything like that. I believe Dr Burson spoke on that recently in 1 of these posts. Anyway, you’re probably right on, as I said, but they’ll NEVER admit that unless the OD deaths from IVing the strips becomes something they can’t just sweep under the rug. But the reality is that a SINGLE OD death is 1 too many if it could’ve been prevented realistically (in a feasible way that would not put thousands of others at risk – like w/drawing opioid treatment altogether).

      Reply

    • Posted by Benjamin K. Phelps on February 7, 2013 at 1:37 pm

      Oh yeah, & 1 other thing: there is VERY little money to go around for opioid dependency/addiction research. Most meds available out there have patents long-ago expired, so new formulations have to be patented, or new indications must be made. Take methadone, for example. Since it’s already used for opioid dependency, no new indication could be made for that. About all they could do would be to come up with an administration system (like one you swallow that doses you slowly over a month or something of that nature) to patent. Buprenorphine was NOT indicated for addiction back when it was being studied in the 90’s (& probably some in the late 80’s.) So that was their ace-in-the-hole. Now they have left the indication behind & centered in on the formulation a person takes as the item to patent. I’m not sure they’ll have much they can patent after that unless they find a new indication or formulation all over again. But at that point, they have competition w/their old formulations in the forms of generics, as is the case w/Subutex versus generic Roxane buprenorphine tablets. They’d have NEVER let the patent expire on Suboxone (as they did w/plain bupe) w/out a fight in the form of getting a new patent on it some way, somehow, b/c Suboxone is where the profit is coming from, not Subutex.

      Reply

      • Posted by Dan Lester on February 25, 2013 at 7:04 pm

        exactly! i agree 100 percent. they are making a friggin fortune on suboxone and i also believe that is why docs in cahoots with the company dont like prescribeing subutex even though out of pocket is cheaper on us as petients. PEACE..wel said

      • I think doctors don’t prescribe it because they are afraid patients will misuse it. RB reps have fanned the flames of that fear.

  21. Posted by john on February 11, 2013 at 11:34 am

    If a child put this in its mouth it would start screaming and spitting.they don’t taste like oranges there horribly.this has to do with money.most people prefer tablets do not stop making them.stop making the films that’s where your loosing money cause people dont want them

    Reply

  22. Posted by Dan Lester on February 24, 2013 at 3:22 pm

    i find it to be all bs. ive been on suboxone off and on for nine yrs now. ive never abused it, yet they say theres a higher potential for abuse with tablets? ive seen people disolve and shoot the strips as well as the pills. i think thats bs to. ive been on it this long and its the only thing that helps me live my normal life. its people that abuse and sell it that ruin it for worthy patients. i honestly cant stand the strips. i get head aches, rash, and hate the taste. they say its neutral taste? i gag off the strips and never did on tablets. im going to possibly lose my insurance and for the other reasons im hopeing my doctor will put me on subutex. ive been on this medication for this long bc im busted up from head to toe from car accidents and work accidents. it helps enough with the pain to where i can deal with it. idk y, but it helps me think “ok man im hurting today, but its not that bad”. i had 7 months clean after a long period of being on suboxone, i hurt my hip and back again, and my 1st suboxone doctor i ever had, put me on morphine (wouldnt use buprenorphine) for 3 months and cut me off cold turkey, obviously i went back to useing. long story short, i have a friend thats a “higher up” at a hospital, he got me back into the suboxone prgram, my doctor is awesome and she cares, she listens. with in 6 months of being back on it, i got my own place again, started collecting materialistic things, get my license back on a month, and got visits through the court with my kids…the medication does help. i just belive some of us are going to be life long patients….PEACE

    Reply

    • Posted by Benjamin K. Phelps on March 3, 2013 at 12:23 pm

      The only thing that breaks my heart about ALL of this is that when I read Dan’s article above, I just can’t help but wonder why EVERYBODY wants to push & push & push those of us doing well in treatment to “Hurry up & get off that stuff!!!” As if the numbers being less than 5% success once a person does so (however motivated s/he may be) don’t speak loud enough to them that it’s NOT a good idea!? If the patient wants to get off, that’s one thing, & it can’t be helped. But I constantly read that a clinic in someone’s area is a horrible, money-grubbing company b/c they “don’t encourage enough patients to hurry off the medication”. That’s NOT THEIR JOB TO DO! They are there to help us, whichever way WE, as patients, decide we are ready to go. I don’t WANT to be at a clinic that’s pestering me constantly to hurry up off methadone. I don’t need that. I’m doing wonderfully on it – something I could NEVER say after abstinence-based treatment (6 of them ranging from 3 weeks to 2 years, as well as 2 years & 7 months in prison, all clean time except like 3 times of using Percocet.) A clinic’s job is to provide treatment – medication & counseling – & to help the patient to move toward a better life & one of productivity as a normal human being (not caught up in the seeking, buying, & using of substances all day, every day), & to dispense medication for as long as treatment is working & until the patient is ready (if ever) to attempt a taper. Yet every time I turn around – which is like at LEAST once a year – some senator in some random state decides s/he has this thing all figured out & introduces a bill to limit our time in treatment, limit our takehomes, limit our driving privileges, limit our ability to keep our kids with us when going to the clinic & back home, limit our dose, & limit our ability to get into treatment to begin with – all based on some idea they’ve gotten from God-knows-where, b/c these ideas CERTAINLY DO NOT jive with the findings of ALL the studies that have been done for nearly 50 years now relating to methadone & treatment with it for opioid dependence. Is it not somehow clear enough that a 96% relapse rate means that we’re almost doomed to NOT DO WELL upon leaving treatment, ESPECIALLY when forced to do so before being absolutely ready to do so ourselves? I would be scared to death (not of withdrawals, but of being able to stay clean after getting to zero – we’ve all been through w/d’s a thousand times & lived to tell about it for the most part… It’s staying stopped that we cannot successfully do) if I were wanting to taper that I might have a problem after getting completely off. I cannot IMAGINE what I’d feel if they came along & said “You’ve been in MMT long enough. Time to get you off & ‘drug-free'”, which for whatever reason, seems to be REALLY important to these people that have absolutely NOTHING to do with me or my life or my status when it comes to taking or not taking medication daily. I’ve not yet seen a senator attempt to pass a bill to limit my ongoing Nexium prescription – even though if I stop taking it every single day, I’ll get horribly sick w/heartburn that is agonizing. I’ve yet to see them attempt to limit my ongoing script for trazodone, or Depakote… Or even Lunesta, back when I was getting it – & it’s controlled (indicating that this is all a plight against the addicted population that receives medication-assisted treatment). And I keep getting from people that “Well, they only THINK there’s a problem w/the endogenous opioid system for people like you… They can’t & haven’t proven that!” Okay, so tell me about what they know about your kid’s Ritalin, Remeron, & Depakote, if you wouldn’t mind. Sure, we know that Ritalin helps ADHD… We know that Remeron helps w/depression & helps w/sleep… And we know that Depakote helps w/bi-polar… But we have NO KNOWLEDGE what the true mechanism is for their effectiveness – it’s ALL theoretical at this point. We know what the drugs DO, but not HOW they do these things. We know what methadone DOES, but not HOW it does it, per se, or all of WHY it does it (we do know SOME of why it works… i.e. the filling of opioid receptors means that they no longer will cause cravings by not having anything bound to them, etc). So why is this different? My friend of 20+ years, while trying to be helpful in his own way, the other day told me that he can’t see or understand (& he’s a nurse) why methadone would help a deranged chemical balance in the e. opioid system. I explained in GREAT DETAIL what is known & what is hypothesized about this subject, & he still was like “Nope, don’t see it.” He suggested that this is all in my mind & I just am scared to let go of it & try. Then he tells me his 20 year old son has always been on lithium for bi-polar II disorder & that without it, he is unpredictable in his behavior, yada, yada. So I’m like “EXACTLY!!! That’s what I’m talking about here with my situation.” Yet, he still thinks it’s different & makes excuses for why. So I mentioned that ALL chemical systems in the body are capable of dysfunction, & asked him why he would then reason that the e. opioid system would NOT be, too. I got no answer to speak of. That’s not logical or critical thinking, nor is it sound reasoning. Now I realize the theories could be wrong – I realize also that I could be wrong in why I believe it works for me. But what I DO know beyond a shadow of a doubt is that since I went from never having experienced opioids other than a controlled amount in the hospital in 1993 & 1994 during surgery to doing 20 bags (2 bundles) daily in 1995 within a 1 month period (b/c I was countering each shot with cocaine – thus, my tolerance went sky-high VERY quickly), I have NEVER been capable of feeling “normal” without opioids in my system… including after being in prison for almost 3 years & not having any to take other than those 3 doses of Percocet during the first 6 months of being in (1999). By the time I got out in September 2001, I should have returned to about as “normal” as is possible in that amount of time. Yet, I craved every day, & relapsed in LESS than a month. The day following my relapse (a friend handed me 3 Vicodins & I swallowed them before I thought about it in any detail), I was back out writing scripts again, & arrested in less than 4 months after getting out of prison for having done the same. Nobody will EVER convince me that I did change my body’s chemistry beyond repair in those early years of using SO much opioid drug, & therefore, it makes PERFECT sense to me that I would need to take methadone for life. I don’t like that fact, but it currently seems to be the way it is, & I must live with it. Trying to reject that & refuse to accept it in any way won’t change it, & would, in fact, lead to me getting off, relapsing, & ending up either dead or in prison for 10+ years as a habitual offender (which I will get if I EVER get another felony). I’m NOT willing to take that risk, by any means in the world. I have too much at stake to take such a chance as that. There is NOBODY in the entire world that will have to fight the fight I will if I’m not on methadone. Nobody else will have to live through the horrific cravings I’ll have 24/7 without it; nobody will have to die or go to prison for over a decade if I get arrested or OD again. Therefore, there is nobody in the world that has ANYTHING invested in my being able to say that I don’t have to take methadone to help me… That I’m “drug-free!!”, as they seem SO intent on making me & others say. Such people need to get a life, a job, & a clue that it’s not their business, nor is it their own life they’re trying so hard to ruin – b/c I don’t care how good their intentions are, or how misguided they are – the net result of their plans will be the destruction of thousands of lives & the downfall of many long-term clean/sober people out there who depend on their treatment to remain so.

      So my original point: I hate that you (@Dan) came off the treatment, since it was working for you & you could’ve avoided the problems that occurred again, causing you to have to return to treatment. BUT, I do wish you the best this time around, & I hope you will consider this if you should start to think again in the future that perhaps ditching treatment is the way to go again. I’m not saying you’re doomed to fail, but the odds are against you, unfortunately (& me too!) So if you’re able to stay in treatment (i.e. – don’t lose your insurance, or ability to pay, etc), give it serious thought, my friend.

      Reply

      • Posted by Benjamin K. Phelps on March 3, 2013 at 12:39 pm

        ****Correction: It should have read, “Nobody will EVER convince me that I *didn’t* change my body’s chemistry….” Not that nobody will ever convince me that I DID change it…

        Quick question for Dr. Burson: I’ve read & been told that NC is now no longer a “monthlies” state (meaning the state now no longer allows for monthly takehomes of methadone, unless the patient has already earned that many or gets an exception). Is this accurate to your knowledge? I’m not sure where that information originated, & that is why I’m trying to get a little deeper info on it. I know that some clinics, when wanting to change their own policies, will deflect by saying it’s “fed regs” or “state regs” rather than admitting they don’t like current policy. My clinic used to allow monthlies & about 3.5 years ago, stopped doing so unless you already had them. When I transferred there, I’d been on monthlies, but the previous clinic doc had yanked them away b/c of a false positive (the 6th one I’d had at that clinic – all 5 previous ones had been proven false w/my own money @ $55 a pop, the 5th one turned out to be the clinic’s error that I had to find, since they refused to bother to look for the error, but I couldn’t find the problem w/the last one). So when I transferred, I didn’t have them anymore & thus, couldn’t get back to them. Talk about unfair & causing just a little bit of animosity towards them….. I’d even offered to give a hair sample & let them choose a lab to test it (which shows 90 days’ worth of drug use) & I would pay full price for it, but of course, they refused – b/c it would’ve helped a patient, rather than help the clinic, which wasn’t permissible at that place. So anyway, I digress, I know – I’m wondering if we’ve seen the last of being able to earn monthly TH’s here? That would really bother me, seeing as I’m 100% compliant (the bike being stolen is the closest thing they have to being able to say I’m out of compliance in any way…) I’d like to know that I can get to monthlies again at some point at another clinic, as I do plan to transfer out of my current one as soon as I’m financially able.

      • sorry, I forgot to answer you. Yes, you can get monthly take homes in NC. but individual clinics sometimes won’t grant that level because they think it’s not enough support for the patient. You’d better call the new clinic in advance to see for sure, and I’d say make sure you talk to the program director.

  23. Posted by dora miller on April 15, 2013 at 3:40 am

    Lets just say I’m a person who is allergic to so many chemicals in pills and when I had my car accident that almost killed me leaving me with screws and rods to put me back together I got hooked on my pain pills and later on went to the suboxone clinic to get help. The suboxone tablet is all I have known and I done great on it til the films came out, after taking for two weeks I started having problems with breathing and so on so I talked to my Dr about it and he put me back on the tabs and guess what those problems went away then a few months later I had to go on them because te Dr said I had to and I tried the nasty things again, guess what the same problems occurred three days after taking and note I wasn’t taking anything else with it so I know it wasn’t that. I know that the films were made with totally different chemicals than the tabs were. And I also get so mad when these Dr act as if they know how your suppose to feel or they say you cant tell a difference between the films or tabs well I will have to call bs on that.

    Reply

  24. Posted by Nick on May 14, 2013 at 5:08 pm

    I was just leaving Rite Aid pharmacy and found your site through a Google search with keywords related to Suboxone discontinuation. I’ve been taking this drug for years and today was the first I heard of it being discontinued, and that was when the pharmacist called me to state they tried ordering it and discovered it had been discontinued. I half didn’t believe him, which doesn’t say much for my trust in big box pharmacies; however, he did state he had a generic equivalent to fill it with. The reason for my comment is because I noted in your post you stated generic buprenorphin didn’t contain naloxone; however, looking at this generic substitution the description states it as being Buprenorphin-Naloxone 8-2mg tab, the same as the brand Suboxone. Manufacturer is Actavis Elizabeth. The price was $389.49 for 60 tablets, almost half what I was paying for the brand. I only wish I knew about the generic earlier. Strangely, he didn’t mention or offer the film version and I wasn’t aware of its existence. Being in the parking lot I didnt read too many of the other comments so this may have already been mentioned, but if not i thought I would mention it.

    Reply

  25. Posted by Dave Webb on June 24, 2013 at 2:52 pm

    I have been on Suboxone for nearly nine years. I have always had the brand name tablets. Fortunately for me my insurance has always covered the majority of the expense. About two months ago, my doctor and I decided I would try the film for the first time. i did not like it very much at all. It definitely felt different than the brand name tablets. I decided I was not going to continue with the film and was planning to switch back to the tablets. The next month when I went to get my prescription filled I was told that the brand name tablets were not available, that they had been discontinued. Like someone else mentioned, I really did not believe the pharmacist or I thought they were mistaken. I had to settle for trying the generic 8mg-2mg pills. I have not really liked those either. So now I’m thinking about going back to the film. But I sorely miss the brand name tablets. Neither the film nor the generic tablets have the same efficacy as the brand name tablets. I too believe it was more of a financial decision than anything else that drove the discontinuance. So needless to say, I am saddened by this development but will make do with what is available.

    Reply

    • Actually, I’ve heard rumors that the company is still making Suboxone tablets. Maybe you could ask your pharmacy to order them for you, to see if they are available.

      Reply

  26. Posted by cm4745 on August 5, 2013 at 9:32 pm

    I really think this is bull. Why should people who are doing the right thing have to suffer from irresponsible behavior. I honestly feel that alot of these pediatric over doses may be from parents deliberately giving this medication to there children as they have been addicted from birth. I only say this because I work in the medical field and have seen mothers do this firsthand , to ease their childrens withdrawals. Normally people that have opioid addiction know alot more than what doctors or people would like to think, meaning I have seen several patients come in that have medicating themselves with this medication from the street. I’m not sure how this medicine is getting so big on the street level but we have seen several patients that have come in and have actually been taking it as it should be prescribed. This medication is changing lives and I believe this change will cause some patient to go back to old lifestyles. We have several that claim the films cause the underneath of their tounge to become irritated or almost raw. I’m hoping the generic brands wikk continue to manufacturer this medication so that it can continue to save lives of so many. It will be heartbreaking to see how many good people will miss out on being clean and having normal lives because of so many others carlessness. My hopes and prayers to all of you out there who are in treatment, good luck and gods love to you all, I will be thinking of you all.

    Reply

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