Opana and Suboxone?

[Scabby McSnatch]

So I'm watching Intervention (S05E03 - Sandra) and the addict is addicted to prescription medications. The only opiates she uses are suboxone and Opana ER, She definitely shows signs of opioid intoxication (nodding, itching, tiny pupils) but I dont understand. Would taking the Suboxone not block the Oxymorphone in the Opana rending it redundant?

 

[Lorne???]

Uh, that show is sketchy-and would need more details-they could be using buprenorphine in between?

Remember, Oxymorphone has a very high binding affinity-it’s 10x more potent than morphine IV-so in any case, it would be one of the few opioids that could “breakthrough” buprenorphine to some extent

Of course, doing that would be reckless and dangerous, and Opana ER is tamper resistant

Again, that show is sketchy; also, this doesn’t really seem a BDD question; maybe Drug Culture? Drugs in the media? Hmm...

 

[Tubbs]

To drug culture, sorry Sam and throwdown if it's not appropriate.

 

[Lorne???]

I was going to do that, and my net went slow- you damn Scotsman!

 

[Tubbs]

Supposed to do it after your post friend-o. Lol

As Lorne said, I would put literally zero stock in anything said on intervention, it's a tv show meant to make money. They take plenty of liberties with the truth.

 

[Nursebd]

I'll try to explain a little about the drugs that might make it a little more sense. Suboxone is a combo of buprenorphine and naloxone. Naloxone is an opiate antagonist. This means it will block opiate receptors. The naloxone in suboxone typically isn't absorbed unless injected. Naloxone is narcan. If injected it can cause withdrawal. It is added to deter the abuse of suboxone. It's absorbed poorly through oral/sublingual administration. It is inactivated by the liver. This allows the buprenorphine to still get to the opiate receptors. The buprenorphine is a partial agonist. This means that it does activate some of the pathways that other opiates do but to a lesser extent. It prevents withdrawal but doesn't really give someone a high. (Obviously it can be abused to get high.) It also blocks some of the opiate receptor sites but it doesn't block all them. It is still possible to get high off of other opiates. Because some of the opiate receptor sites are being blocked with the buprenorphine, you would need more of the drug to get high. Also the half life of buprenorphine is very long, 22-42 hours, which means it stays in your system for days, with no effect being felt, continuing to block/bind those sites. This is very dangerous as most users won't know exactly when it is out of their system and could continue to use higher doses that can lead to an overdose. So even with taking suboxone it is still possible to get high with other opiates it would just take a higher dose. But obviously that can lead to an overdose.
I hope that was helpful. I am a nurse and my friend is a pharmacist. She explained it to me and I broke it down more for you.