this article was in the ny times today, first page and long article. so, fyi. a few points. http://nyti.ms/1ag73KD
–though milder and safer than other opioids (and counter to my initial training for suboxone prescribing), people can get high on subox, esp if relatively opiate-naive.
–in terms of safety, since 2003 there have been 420 subox deaths in the US (vs 3625 methadone deaths, and lots more from oxycodone, etc as per my recent emails)
–no surprisingly, some MD have been prescribing suboxone inappropriately (and many of them also have prescribed other opiates inappropriately)
–(again different from my initial training), subox is sometimes being used by injection (the naloxone incorporated is supposed to create withdrawal when given IV and thereby make injecting the drug a strong deterrent. turns out that the level of naloxone may not be high enough, and some people who do get a naloxone reaction find it to be relatively mild and transient). not sure what the real data are here in terms of %’s, but per this article, it is being injected at times.
so, my experience certainly confirms that suboxone (buprenorphine/naloxone) is a commonly used street drug, mostly used to prevent withdrawal, though also perhaps for some opiate-naive patients to get high. i find that it is a really great drug for the majority of my patients on it, often a very complex panel of patients with an array of psychosocial/behavioral problems. but more than 60% (my guess) do phenomenally well, function well, and really get their lives back. this article tempers my enthusiasm a bit, but in perspective i really do find it a great drug for the majority of my opioid-addicted patients who want to/are ready to quit the other opioids.
geoff