Suboxone Diversion Concerns Some Experts

Diversion of the opioid addiction treatment Suboxone concerns some experts, who say in some cases it may be a gateway drug to heroin or opioid use, The Christian Science Monitor reports.

Suboxone, which contains the drugs buprenorphine and naloxone, is being sold on the street along with heroin and prescription painkillers, according to the newspaper.

“The benefits of the appropriate medical use of Suboxone probably far outweigh the potential for abuse,” said Eric Wish, Director of the Center for Substance Abuse Research at the University of Maryland. “But those benefits will be jeopardized if we don’t take care of this abuse issue.”

In contrast to methadone, which is only dispensed at clinics, Suboxone can be prescribed by certain physicians for at-home use. The Food and Drug Administration has approved a generic version of Suboxone and a generic version of buprenorphine without naloxone.

Suboxone can be life-saving, by helping to prevent opioid overdoses, some experts note. After Maryland expanded access to buprenorphine, heroin overdose deaths dropped from 312 in 1999, to 118 in 2009.

Physicians who want to prescribe buprenorphine must get a waiver from the U.S. Drug Enforcement Administration, take an eight-hour training course, and prescribe the drug to no more than 100 patients at one time. Patients prescribed the drug must be given regular urine tests, and are supposed to attend counseling. Doctors must keep detailed records showing the patients are taking buprenorphine as directed.

Some patients sell some or all of their buprenorphine on the street. In some cases, they use the proceeds to buy heroin. While some people buy buprenorphine to medicate heroin withdrawal symptoms, others start with buprenorphine and move on to stronger opioids.

Nationwide police seizures of buprenorphine rose from 90 in 2003, to more than 10,500 in 2010. The number of emergency room visits related to the drug rose tenfold over five years, reaching more than 30,000 in 2010. More than half of the incidents involved nonmedical use of buprenorphine.