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WASHINGTON — Eighteen state public health directors, a growing group of physicians, and a prominent member of Congress are pushing a dramatic expansion of substance use treatment by posing a simple question: Why can’t doctors who prescribe opioids also prescribe drugs to treat opioid addiction?

Their push to deregulate use of buprenorphine, which is used to lessen opioid cravings and withdrawal symptoms, would represent a fundamental shift in U.S. addiction treatment. The medication — and addiction medicine in general — are highly regulated, largely due to fears that opioid-based treatment drugs like buprenorphine and methadone could be misused.


This week, the effort will gain support from Washington: Rep. Paul Tonko (D-N.Y.) will soon introduce legislation to allow any medical practitioner licensed to prescribe controlled substances to prescribe buprenorphine, he told STAT. Currently, physicians must undergo an eight-hour training to prescribe the drug — 24 hours for nurse practitioners and physician assistants.

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  • Danny,

    Subutex does not have the active ingredient Naloxone inside of it. Naloxone is supposed to prevent you from being able to abuse opiods, shortly after taking Suboxone. It’s too discourage addicts from using Suboxone as a gap drug. Subutex does not have that, and there is nothing preventing you from using your drug of choice, then using subutex when you have none, then switching back when you can get your hands on it again.

    What most addicts don’t know is the Nalaxone in Suboxone is very very weak and does largely nothing as long as you wait a couple hours before trying to bypass it. Not that you should want to, my suboxone completely removed my cravings.

    • It is the buprenorphine in both suboxone and subutex that helps with cravings and prevents people from getting high from opioids. They both work exactly the same. The naloxone is in suboxone supposedly to prevent iv use of it. It doesn’t have any affect when taken as prescribed. The naloxone in suboxone causes very severe headaches in some people. Subutex can be an excellent alternative. They really do work exactly the same.

    • I’m wondering why she prefers subutex over suboxone. They work the exact same way but some people get headaches from the naloxone in suboxone. Is it a reason like that or is it something else? The way that suboxone was marketed made doctors believe it was safer. That is why very many doctors will only prescribe suboxone and not other forms of buprenorphine. The company recently got in big trouble for this because it is not true at all. Buprenorphine in general is actually very safe. It has a ceiling affect so past 24 or max 32 mg it has no greater affect. This is good because people pretty much can’t likely OD from it, but bad because it won’t work well enough for people who are heavy users. Sublocade is an excellent option if available to her. It is a monthly shot of buprenorphine that many people are having phenomenal results with. If at some point they choose to stop getting it it wears off over 2-5 months so there is generally no withdrawal at all and if there is it’s extremely mild. Best wishes to her and to you!

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