Suboxone for Pain

In 2002, the FDA approved Suboxone, a combination of buprenorphine/naloxone to help treat opioid dependence. Patients can be prescribed Suboxone in either an in- or outpatient setting, and it can be dispensed at pharmacies for in-home use.

• Suboxone treats opioid dependence

Significance

• Although Suboxone does contain opioids itself, it is not usually prescribed for pain or pain management. Its "on label" use is to assist with opiod addiction and to help patients stay in treatment.

Function

• The active ingredient in Suboxone, buprenorphine, is a partial opioid agonist. This means its opioid effects, such as the ability to act as a pain killer, are limited compared to other medications or drugs classified as full opioid agonists (such as oxycodone).

Effects

• This limited pharmacological response does not increase with an increased amount of the drug. Partial opioid agonist effects have a "ceiling effect" where the effect of the drug has a plateau.

Considerations

• The second ingredient in Suboxone is naloxone, which acts as an opioid antagonist. This is included to keep patients from abusing the drug, by for example, injecting or snorting it to try and beat the "ceiling effect."

Benefits

• Suboxone is only FDA approved to treat opioid addiction. However, any FDA approved drug may be prescribed for uses that are considered "off label" by a licensed physician---as long as the physician believes them to be therapeutic and appropriate.

Warning

• It is not illegal for a physician to prescribe Suboxone for pain and pain management. However, a patient should be aware that it is not considered to be the most effective medication for pain, and data about its use in this way has not been reviewed by the FDA.