1. Jay

    The first thing that came to my mind was how much easier tapering would be with the film. I for one am looking forward to trying it and will talk to my doc about it at my next apt. I would like Dr. Junig to comment on Purdue’s switch from oxy oc to oxy op. Does he think it will create a huge heroin demand in the US? Will patients who can not or will not make the switch be switched to Roxy IR or something else? A good friend of mine who was on the OC’s got sick on the OP’s and so she is being switched to methadone. I told her I didn’t think that was a good move but I’m not a doc. Opinions anyone?

  2. tic

    If the strip is supposed to taste better than the tablet, the tablet must be terrible. I am not having any difficulty with acceptance of the film strip with the $75 off coupon every month through March 2011. After that, I suspect most patients will go with whatever is less expensive.
    I have not heard any fear mongering comments over use of the tablet from my suboxone pharmaceutical rep. at all. All he says is that the film disolves faster than the tablet and 60% of patients say it doesn’t taste as bad.

  3. If patients CAN choose the cheapest formulation becomes the question. During a presentation from a rep from RB promoting the Suboxone Film I was told that any patient not wanting to make the switch “must be up to something” because why wouldn’t they want the film unless their intention was to SNORT the pill! In other words reps are going to doctors and convincing them if they want to stop patients from abuse of bupe (which, as Dr.J pointed out is RARE to begin with) and stop the bad publicity in the media then they HAVE to switch their patients over to the film–because any patient who wants to stay on the tablet has a sneaky alterior motive that has nothing to do with saving money. YEAH, right. He also made it seem as though all patients on Suboxone would be switched immediately to the film because for doctors to do anything else would be “irresponsable”.
    They also said each packet of film has an ID number, which he SAID would help during medication call back counts. What he doesn’t say is that the only way this would work is if the filling pharmacy was willing to take up pharmacist time and computer space to run a database which would track which packets went to each patient. The chances that a pharmacy is going to take on that responsibility without compensation are slim.

  4. shan673

    I have actually taken the film and the tabs and to be honest I agree with what the company is saying. I, personally, feel a lot better taking the film, the tabs seem to make me feel very drowsy and kind of like crap, where I don’t get that feeling with taking the film, not to mention the film tastes better, dissolves faster and they don’t break, crumble, etc. The only slight pain is the packaging and having to cut them if you only want a half or quarter instead of the whole strip. I would definitely take the film over the tabs any day but that’s my preference, anyway the reason I was responding to the above post was because of my agreeing with the company about the comparison between the film and the tabs, the cost is by far better with the film, my pharmacy charged me $11.99 per tablet where I can get 10 film for $17.89, that is by far better for the times my insurance doesn’t cover my meds, my doctor is adamant about everyone switching to the film because abuse is high in my area, to the point where people not only shoot the Subutex they shoot the Suboxone also, and if they are not shooting it they are selling, trading, etc, etc, it has become an epidemic in my area right along with heroine, oxy’s and whatever other opiates people are doing now a days and it is ruining the freedom and ease people like me have with getting Suboxone, I have been on the tabs for 8 years and have been clean for 8 years with no problems but now my insurance wants me to go to drug & alcohol counseling, get prior authorizations, go to the doctor every month instead of every three, which is a pain in the a** since I already went through all the counseling and everything else but now I have to suffer because of the actions of others, I hope the film does crack down on all of the excess so I can go back to just taking my meds without all the bullsh*t

  5. shawnsbruno

    Did Reckitt-Benckiser tell you how easy it is to put the film on a spoon, add water, heat up ,and then inject with a needle. Now that could be a big problem!!!

    • Frankly, they don’t tell me anything. But I would think that buprenorphine has limitations as an IV drug of abuse- at least compared to heron or oxycodone. Buprenorphine has very similar kinetics whether taken transmucosally or intravenously. The long half-life of buprenorphine would make the person develop a tolerance after a few uses– and then the person would have to go through withdrawal for a week or two before being able to get ‘high’ again. I can see how a person could inject it for a ‘high’ once or twice–but after that, the person would be ‘on maintenance’, making further abuse unrewarding.

  6. Quarter-Wit

    Although I agree with most of what you have said in this article, I must note that Suboxone tablets (and Subutex to a slightly greater extent) are “abused” routinely. I know some people that are “maintained” on Suboxone just like “legitimate” users yet they often snort the pills, not so much to get super-high but to “feel good”. They prefer the pills because of this. Also, in theory, one should be able to dissolve the buprenorphine out of the films just like with the tablets in order to make an injectable solution. In fact, it might even be easier and more efficient, with the resulting solution having less colloidal character (undissolved particles), to “shoot” the films. The only thing that the pills prevent is snorting. Even so I can imagine several ways that might be effective in rendering the films powder-like.
    I definitely believe that the reason the films are being pushed so hard is because of money and expiring patents. The only thing they are effective at preventing at this point in time is snorting (which is comparatively rare). In fact, since the films can probably be readily injected with just a little bit of effort and cannot be snorted, they might actually encourage intravenous use since the abuser will often take the easiest and quickest route to instant gratification. Personally, I’ve never understood the appeal of injecting or snorting Suboxone (probably because I’ve never tried it) when simply dissolving it under one’s tongue gives comparable effects. For many, I think it’s just the act of snorting or IVing that they’re addicted to.

    • I am less concerned about abuse of Suboxone than some people; the abuse is, frankly, self-defeating, as the long half-life and tolerance only ends up putting abusers ‘on Suboxone’, where they are unable to get a ‘high’ from their actions. Some people can probably hold things where their tolerance doesn’t escalate, and use infrequently enough so that each use provides a lift– but that in itself is a means of reducing the compulsion to use opioids.
      I agree that many people enjoy the act of snorting an even injecting. It is interesting that even such experiences that are unpleasant initially, can be conditioned as positive experiences if associated with the euphoria from opioids.
      Finally, I may be cynical, but I see nothing but commercial opportunism in the development of the film, and I believe that the company that has reaped such huge rewards from Suboxone would be better to spend their R and D money on things that would truly help opioid addicts– such as larger, lower-dose tablets to aid tapering off the medication. Is it just me who wonders why they don’t make it easier to STOP their medication? Or am I asking too much?

  7. tearj3rker

    Another great article SuboxDoc.
    I also found it difficult to get high from the full agonists after a while. When I was using heroin, my tolerance got so high that it didn’t matter how much I used, the only way to feel an effect was to mix it with other depressants (xanax usually).
    Someone here did mention IV use of Suboxone. I injected a 4mg Subutex pill I was given many years ago early in my addiction, micron filtered , and I did feel a bit stoned for a little while. It wasn’t as intense as heroin, but it did have some appeal in lasting the whole day through. But I couldn’t use any more heroin, so I left it alone for a while.
    My doc prescribed me the film for the first time a couple of weeks ago. And I can see just by looking at it, how much easier it is to inject than the pills. The big turn off of IV pills is all the binders, the need to filter them (preferably) with micron filter. But I’ve seen so many people IV milky claggy pill solutions that are so poorly filtered they have to force it out the needle. Today it makes me sick to remember.
    These film strips on the other hand have far less binders, and would dissolve a lot quicker / more easily, both in the mouth and in the spoon. Why the prescribing doctors in my country, where nearly all people on the Subox / methadone programs were / are IV addicts, can’t see this … They seem to believe the film is harder to abuse? That the tablets are the ones people want to divert, and my preference for the tablets has even made my pharmacist distrustful of me.
    Last time I saw my prescribing doctor, I told him I was worried that Suboxone tablets would cease to be manufactured / prescribed, because of these misnomers about their abuse potential. He said that my concerns were valid, and left it at that. He also said that 4 other patients who tried the film gave bad reports and switched back. He said he would talk to RB about it. Now I’ve read what the reps are telling doctors, I hope he won’t come back sceptical of my motives, which are pure.
    I’ve accepted a lot of things about marketing and capitalism. And even warmed to a lot of it. But seeing these practices happening in something like health care always hits a nerve, especially when it influences a doctor’s decisions, and his / her trust in their clients.

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