Buprenorphine is a life-saving medication that helps people beat opioid addiction by easing withdrawal and reducing cravings. It comes in many brands and formulations.
Buprenorphine is categorized as an opioid. It is a partial opioid agonist, which means that unlike other opioids, such as heroin and oxycodone, buprenorphine only partially stimulates the brain’s opioid receptors. This partial activation leads to what is known as a “ceiling effect” for opioid effects such as euphoria and respiratory depression. The ceiling effect leads many clinicians to consider buprenorphine safer than full opioid agonists in two key ways: it results in a lower risk of addiction than other opioids, and it creates a lower risk of respiratory problems. But because it does stimulate the opioid receptors somewhat, it relieves cravings and withdrawal symptoms in people with opioid use disorder.
Buprenorphine is an important part of treatment for many people in recovery from opioid use disorder. How are they likely to receive it? Here are some popular brands of buprenorphine and what makes them different from one another:
Suboxone
Suboxone is the most popular brand of buprenorphine medication for opioid use disorder—so popular, in fact, that many people use the terms Suboxone and buprenorphine interchangeably. Suboxone comes as a film that you put under your tongue to dissolve and also contains naloxone, an opioid antagonist best known for its ability to save lives in the event of an overdose. Along with buprenorphine, Suboxone also contains naloxone. When dissolved under the tongue as directed, the naloxone in Suboxone doesn’t do anything, but should one misuse it (for example, by dissolving the film and injecting it) the naloxone will block the effects of the buprenorphine, causing sudden withdrawal.
Zubsolv
Zubsolv is another brand of buprenorphine/naloxone. It comes in the form of tablets that you dissolve under your tongue. Like Suboxone, Zubsolv contains naloxone to deter misuse. Aside from the form (tablet rather than film) and being issued in slightly different dosage strengths the main difference between Suboxone and Zubsolv is the taste. Zubsolv has a mint flavor that some people find preferable to the taste of Suboxone.
Generic Buprenorphine/Naloxone
A generic for Suboxone has been approved by the FDA and can be ordered at the pharmacy as buprenorphine/naloxone (no fancy names). Some insurers will only cover generics, and not the brand name version. As with all medications, some people find that formulations from different manufacturers work better or have different side effects than others. Generic buprenorphine/naloxone contains the same active ingredients as brand-name medications.
Subutex
Subutex contains only buprenorphine, with no naloxone. It comes in the form of tablets to be dissolved under the tongue. Because it doesn’t contain naloxone, Subutex is considered to be at higher risk of misuse or diversion, so many clinicians (including those who serve Workit Health members) prefer to prescribe buprenorphine/naloxone medications. Some providers do prefer Subutex for pregnant patients.
Sublocade
Sublocade is a once-a-month injection of buprenorphine. Patients start their treatment on Suboxone, Zubsolv, or Subutex until they reach a stable maintenance dose before transitioning to Sublocade injections. A big advantage of Sublocade is that you don’t have to worry about taking films or tablets daily. A drawback to Sublocade is that it must be injected at an office, clinic, or pharmacy, so it can be harder to find. Another is that it lasts for 28-30 days after the last injection, which can complicate things if you need opioid painkillers for emergency surgery or if you decide to taper off of buprenorphine.
All these forms of buprenorphine can only be prescribed by physicians, nurse practitioners, and physician’s assistants who are authorized to prescribe controlled substances. To find buprenorphine treatment in your area, the NAABT has a directory called Treatment Match, which will connect you with local providers. The Substance Abuse and Mental Health Services Administration (SAMHSA) also offers a Buprenorphine Practitioner Locator. If you’re in a state where Workit Health operates, Workit-affiliates clinicians prescribe buprenorphine/naloxone, including Suboxone and Zubsolv, via our telemedicine platform to provide medication-assisted treatment online.
Regardless of what brand of buprenorphine you and your healthcare provider choose, you should know that buprenorphine is the evidence-backed treatment for opioid addiction.
