Archives for October, 2011


Suboxone vs Buprenorphine: Organized Ignorance?

I have written in the past about my feelings about ‘Suboxone Film’– that it is a product that serves only one purpose, and that is to block generic competition from the Suboxone market. Today, a Bloomberg article discussed the current nature of the buprenorphine/naloxone business, and the efforts by RB to prevent generic competition from making roads that would lead to significant price reductions for healthcare consumers.

The point missed by the writers of the Bloomberg article, though, is the same point that is missed by many physicians– even by many addictionologists. The dirty secret that RB does not want anyone to realize is that the equivalent of generic Suboxone is already available, in the form of orally-dissolving tablets of buprenorphine.
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Did I Say ‘Epidemic’?

I will get to my promised response to my last post-- the one that called out the detractors from Suboxone.  But first I have to share the story I read in the Maine Sunday Herald today about the surge in overdose deaths over the past year or two.  The article mentions the 28,000 overdose deaths across the US in 2007-- the last year for which we have such numbers;  numbers that have surely risen since then.  The article also describes, more personally, the current overdose death rate in Washington County, Maine, which has doubled in recent years.

My point in promoting this type of information is to emphasize the magnitude of the problem.  It is one thing to argue about marijuana laws, where the death rate is comparatively tiny.  But people using opioids die at an alarming rate. 
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Reactions to Suboxone

As many readers know, I maintain a forum for people who take buprenorphine for opioid dependence. The initial purpose of the forum  was to serve as a source of accurate information about the new medication. Now, several years later, the forum is also a gathering place for people who share certain interests.

Studies have established a connection between opioid dependence and certain personality traits, including a tendency toward depression. In my conversations with people addicted to opioids, many describe an emptiness experienced throughout their lives. Opioids, prescribed or illicit, initially eased that emptiness, relieving the depression and for some even giving a sense, for the first time, that life was worth living.

I suspect that the emptiness experienced by people with borderline personality disorder is akin to the emptiness that some people find responsive to opioids.  Over the years I've had many people write to me, independently, about a ‘hole’ they felt before taking pain pills. I suspect that the current studies of the antidepressant actions of buprenorphine are examining similar effects.
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