Suboxone Tablets Off the Market in March

New formulations of Suboxone, and crystal meth’s impact on the gay community were two of the topics discussed at the recent annual meeting of the New York Society of Addiction Medicine. This is the first of a two-part report on the meeting, “Addiction Medicine 2013: Emerging Problems, Current Treatment.”

Suboxone (buprenorphine and naloxone), used to treat opioid dependence, will no longer be available in tablet form starting in March, because of the risk of children becoming poisoned after swallowing the drug. The company has switched to making a film version of the medication, which is put under the tongue.

Dr. Edwin A. Salsitz, MD, Medical Director of Office-Based Opioid Therapy at Beth Israel Medical Center, explained at the recent New York Society of Addiction Medicine annual meeting that the new formulation is safer because it is difficult for children to get into the film strip packages.

The U.S. Poison Control Centers found the rates of accidental pediatric exposure with Suboxone tablets were 7.8 to 8.5 time greater than seen with Suboxone film, according to a news release by the company that makes the drug, Reckitt Benckiser Pharmaceuticals.

Other formulations of buprenorphine are being studied, Dr. Salsitz said. He described a study, published in the Journal of the American Medical Association in 2010, that found buprenorphine implants placed under the skin on the inner arm in people with opioid dependence resulted in less opioid use over 16 weeks, compared with placebo implants. The implants are not yet commercially available.

“I think this will be a useful product in terms of reducing the diversion/misuse problem with buprenorphine,” Dr. Salsitz said. “It’s very much needed.”

Buprenorphine is also available in a seven-day transdermal patch (sold under the name Butrans) for treatment of moderate to severe pain. It is not approved for opioid addiction treatment, and it is currently illegal to prescribe it off-label for this purpose, he noted. Dr. Salsitz noted the patch, like the tablets, could lead to accidental pediatric exposure.

Gay Community Sees High Rate of Crystal Meth Use

Crystal meth use is pervasive in a subset of the male gay community, according to the director of the Addiction Institute of New York. Petros Levounis, MD, says in this community, abuse of meth and other substances may help them deal with social stress and discrimination.

“Rates of substance use disorders are somewhat higher for people who identify as gay, lesbian or bisexual,” Dr. Levounis said at the recent annual meeting of the New York Society of Addiction Medicine.

He noted, however, that people who identify as not completely gay or straight have much higher rates of substance use disorders than those who are completely gay, straight or bisexual. “Maybe these people don’t have the comfort of having a stable sexual identity,” he said.

Meth is a particular danger in the gay community because it decreases inhibition and judgment, while increasing sensation-seeking and resulting in extreme sexual arousal. This leads to unsafe sex and HIV transmission, Dr. Levounis noted. “The internet  has exacerbated this problem by making both buying drugs and finding sex partners easier.”

Although meth can cause erectile dysfunction, many male meth users use erectile dysfunction medications to address this problem, he added.

Gay men who have body dysmorphic disorder, or “reverse anorexia nervosa,” in which they see themselves as smaller than they actually are, may use meth to feel better about their appearance.

The good news is that patients can recover from meth addiction, Dr. Levounis said. Because patients often experience an intense return of cravings from 45 days to six months after stopping meth use, treatment should last at least six months. Treatment can include group psychotherapy, individual counseling and family therapy.

23 Responses

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    December 30, 2015 at 9:08 PM

    This is all BS!!! I’ve been off my white tabs for 2 days! Back on the orange octagonal!
    My mouth is completely tore up! This is just not fair! I’ve been off opioids for 10 yrs, 1/2 white tab/day! I thrive having my own business and work hard everyday! I have severe addictive behavior and my 1/2 tab/daily keeps me functioning at a high level of society! The poor addicts make it impossible for the functioning to function, they snort, shoot and ABUSE everything they get there hands on….. It’s not really fair for the ie. maintenance patients!

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    July 21, 2014 at 7:01 PM

    I have been on suboxone for about 4 1/2 yrs. I started out on the pills 8mg, then they switched me to the strips 8-2mg 3 times a day. And I will just say the pills are better. They last a lot longer then strips to. But my doctor retired and left me hanging with nothing. So now I am having to buy them from the streets. Cause all the doctors are full with their 100 max limit.

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    Jessa Perry

    June 6, 2014 at 6:48 PM

    Hi im jessa, I have been on suboxine film for a year– my life is so much better!!!

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    Renee Robertson

    November 13, 2013 at 9:27 PM

    I’m a married, 47 y/o mother and middle manager for a large US-based company who requested Suboxone after feeling that I had become addicted to hydrocodone for fibromyalgia and back injuries. In addition to getting off the hydro, I thrived on Suboxone (was later switched to subutex because it’s cheaper), and found I could manage my pain with one pill per day instead of 4 – 6 hydros plus 8-10 ibuprofen. I had been nauseated all the time and had elevated liver enzymes. Since starting on sub, I’m doing wonderfully and my regular bloodwork is perfect. I am sick and tired of big pharmaceutical running our lives and assuming that everyone is abusing or selling their prescribed meds! What about alcohol? Alcohol causes more deaths, accidents and murders than any drug on the planet, and it’s readily available on every corner! Children can easily get into a parents’ liquor cabinet and die from alcohol poisoning…they can overdose on regular OTC meds in the family medicine cabinet! Good grief, is there no end to their greed? Some people have chronic pain and/or opioid dependence issues. I do not touch any other drugs or even drink, but I’m tired of the constantly shifting laws surrounding the one medication that has made my life manageable. Our lawmakers need to take control, not payouts. This is clearly a case of the tail wagging the dog. Disgusting

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    billy Thompson

    July 31, 2013 at 8:52 PM

    Well, I’ve been on suboxone for almost two years & my life has mad a complete 360!! Now that I have some severe back problems with pain so bad that not even the 3 8mg tablets I that can kill the pain. My doc mentioned me coming off soboxone and back on pain pills. I told him that’s not an option for me, so I see a back specialists on the 14!! What to do, what to do???

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