Suboxone is a combination of
Bupenorphine (suboxone) It has paial agonist in mu receptor; thus, it has high affinity, less efficacy, slow dissociation. Thus, they have ceiling effect and hence there is no risk of respiratory depression and less chance of abuse As this drug has an increased first pass metabolism it is not given as oral route and given as sublingual route to improve absorption But some of the patients using substance rather than using it in a sublingual route they crush the drug used it as intravenous route To avoid the abuse of drug the drug was marketed as a combination of buprenorphine and naloxone which is called suboxone. If this drug suboxone is used by sublingual route the naloxone is not absorbed and buprenorphine alone is absorbed and thus it acts as detoxification regimen If suboxone is crushed and injected as IV naloxone is rapidly absorbed and acts as an opioid antagonist and results in severe withdrawal. Thus, it has a less chance of abuse and can be prescribed without license agreement Ref.kaplon and Sadock , synopsis of psychiatry, 11 th edition, pg no.660
naloxone+ naltrexone
methadone+ buprenorphine
naloxone+ buprenorphine
.LAAM+ heroin
Substance abuse