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Suboxone was developed as a treatment for addiction to opiate-based painkillers. Suboxone itself is a very powerful painkiller, 30 to 40 times as effective as morphine.

Drug Has Not Yet Reached Potential for Treating Heroin and Opiate Addictions

At the Maine Correctional Center, a copyrighted story in the New York Times tells us, a correctional officer named Mike Barrett noticed something suspicious when he opened a Father's Day card sent a month earlier. Quickly slicing open the envelope with a knife, he held the card up to the light to look for traces of an orange powder. Then he placed the envelope into a shredder so it could be burned. His scrutiny of a seemingly harmless greeting card stemmed from the prison's recent experiences with a new form of drug smuggling.

Confederates of would-be prison drug dealers have made an anti-addiction drug called Suboxone the latest focus in the war on drugs. Sold in strips that melt under the tongue, Suboxone can be pulverized and sprinkled on paper. Then children use crayons to draw over the Suboxone dust, trapping it on the page. Smuggled into a prison, greeting cards laced with the anti-addiction drug can be cut into quarters and sold for $25 a hit.

What is Suboxone and why would anyone go to great lengths to smuggle it into prisons?

Suboxone, also known by its chemical name buprenorphine, was developed as a treatment for addiction to opiate-based painkillers. Suboxone itself is a very powerful painkiller, 30 to 40 times as effective as morphine.

The strength of the drug allows the patient or user to get the same feeling as obtained from a much larger dosage of fentanyl, heroin, hydrocodone, oxycodone, or morphine. When the patient or user stops using Suboxone, there are much milder withdrawal symptoms because a much smaller dose is needed for the same effect on the brain.

The potency of Suboxone makes it a useful tool for helping addicts kick their habits, but it also makes overdose a real possibility. Medical professionals have to choose a precise dosage of the drug to help their patients, in controlled settings, get off drugs. Suboxone works in a way very similar to the better-known methadone in helping addicts quit without going "cold turkey." Like methadone, Suboxone can be used for treatment or to get an illicit drug high. Unlike methadone, Suboxone won't cause its own withdrawal symptoms if a single daily dose is skipped.

How Suboxone Is Used for a High

People taking Suboxone recreationally typically crush and snort the drug. It induces a rush of euphoria like heroin or opium but it also has a slight "upper" effect. Illegal use of Suboxone in Scandinavia is a  more common problem than illegal use of amphetamines (meth). In recreational use, however, there is a constant risk of taking too much and going into a coma.

How Suboxone Is Used to Stop Addictions

People given Suboxone to help come off other drugs usually take a single 8 mg tablet per day at first, progressively taking smaller and smaller doses until they do not need any more. In the United States, only a limited number of psychiatrists are allowed to prescribe the drug, and they cannot provide the drug to more than 100 patients at a time. Each visit to the psychiatrist usually costs the patient about US $300, which is12 times the cost of the drug bought illegally on the street.

Legal restrictions on the use of Suboxone in America and Australia are severe. Before 2006, American psychiatrists were only allowed to treat 8 patients at a time, and federal law required patients to be enrolled in group therapy similar to a daily Narcotics Anonymous meeting, but run the psychiatrist authorizing the prescription. Even now, doctors have to request an exemption from the stringent regulations placed on most physicians dispensing the drug, after they have had one year's experience in treating patients with the drug.

In Australia, doctors may treat as many patients as they wish, but the patient must go to the pharmacy every day to get their medication for that day to ensure the drug is not used illegally. In America, the cost , and, in Australia, the inconvenience of getting Suboxone lawfully causes many people to try to treat their addiction with Suboxone they buy from drug dealers off the street.

The Future of Suboxone

This brings us back to the topic of the use of Suboxone in prisons. Only seven states in the United States permit drug-addicted prisoners to be treated with Suboxone, and then only under limited circumstances. Ironically, in most of the United States, prisoners who want to kick their addictions to opiates while behind bars are most likely to seek to obtain Suboxone smuggled into prison from illegal drug dealers—which most states believe would merit putting still more people behind bars.

  • Abby Goodnough and Katie Zezima, "When Children's Scribbles Hide a Drug," New York Times, 20 May 2011.