On 24 February 2007 the combination drug, Suboxone,1 was launched in Ireland. The Department of Health has established an expert group to consider the implications of the introduction of this drug and its use as a treatment for opiate dependency. In order for this drug to be prescribed, a system similar to that existing for methadone, including a protocol and a central register, will be required. 

Made by Schering-Plough, Suboxone is taken by placing the pill under the tongue and allowing it to dissolve. The product contains two active ingredients – buprenorphine, a partial opiate agonist, which helps manage the cravings associated with opiate withdrawal, and naloxone, an opiate antagonist, which prevents overdose if the drug is injected. Suboxone tablets are available in two strengths (containing either 2 mg or 8 mg of buprenorphine). The naloxone content is one-quarter that of the buprenorphine content. This drug is taken daily. Since Suboxone is eliminated through the liver, the dosage needs to be lowered for people with mild or moderate liver dysfunction. This drug is not recommended for people with severe liver dysfunction. According to the producers, Suboxone should not be used during pregnancy. If a woman becomes pregnant while on Suboxone treatment, she should be changed to another opiate substitute. The respiratory depressant effect of Suboxone is amplified when the drug is consumed with alcohol or benzodiazepines.

The introduction of Suboxone to Ireland provides another choice of treatment for problem opiate use, as well as an opportunity to identify which substitute is most suitable for different sub-groups of patients. 

European Medicines Agency (2006) Suboxone: Summary of product characteristics www.emea.eu.int/humandocs/PDFs/EPAR/suboxone/H-697-PI-en.pdf