contains (in addition to buprenorphine
) naloxone not nalorphine. Naloxone has minimal oral/sublingual bioavailability and needs to be injected to have any opiate
antagonist effect. The theory is that suboxone will work identically to subutex
(pure burpenorphine) if taken as directed, and the naloxone will only take effect if the pills are injected.
There is some discussion as to exactly how effective the naloxone is. Buprenorphine is a partial agonist that has strong binding affinity to the opiate receptors (hence it will replace morphine
/methadone molecules and because it only partially activates the receptors will precipitate a withdrawal
in an individual dependent on most full agonist (the only exeptions to this rule that I know of are the likes of etorphine and carfentanil for which diprenorphine is used as an antagonist; these are used for sedating and reawakening elephants and rhinos etc.!)), and there are questions concerning how effective naloxone is in displacing it; i.e. there are a few people who inject suboxone. But this will only be an issue if you chose to inject.
You are simply mistaken about being able to take a vicodin or a percocet when on methadone
and get pain relief. The paracetamol
/APAP might help a little, but if you're taking any quantity of methadone, the minimal levels of hydrocodone
in vicodin and percocet would not make a difference. In pure form at seriously high doses they could be used. Further methadone itself could also be uses as a pain killer. If people didn't know you had a habit, and give you a usual dose of pain-killers, this would not do a great deal.
I really don't know what the pain-relief situation would be on buprenorphine. I suppose a higher dose could be used. Some people report getting effects from using heroin
over buprenorphine, others don't. I don't imagine they'd give you elephant tranquilizers, which might work, if you took sufficiently little not to kill you!