Subutex and Suboxone both treat opioid dependence, also called opioid use disorder or opioid addiction, with the same main medicine, buprenorphine. The difference is that Suboxone also contains naloxone, an opioid blocker added to discourage people from injecting it. The Subutex brand was discontinued in the United States in 2011, but generic buprenorphine-only tablets are still prescribed in certain situations.
For most people starting treatment today, the choice between the two is made by the prescriber based on health history. This chapter compares the two medicines side by side and explains when each is used in buprenorphine-based outpatient treatment.
What Are Subutex and Suboxone?
Both medicines contain buprenorphine, a partial opioid agonist. It activates opioid receptors, the same receptors that heroin, fentanyl, prescription painkillers, and other opioids act on, but only partway. That partial effect helps reduce withdrawal symptoms and opioid cravings without the full effect of full opioid agonists.
Subutex: Buprenorphine Alone
Subutex was the brand name for a sublingual tablet containing only buprenorphine hydrochloride, which dissolves under the tongue. Generic buprenorphine-only tablets work the same way and are what pharmacies dispense today when a prescriber orders a buprenorphine-only prescription medication. Both forms are commonly prescribed medications for opioid dependence.
Both products can ease withdrawal and cravings when appropriately prescribed, but identical labeled doses do not always produce identical exposure across tablets and films. Drug-test windows also vary by formulation, dose, and laboratory. Our chapter on how long buprenorphine stays in your system explains those estimates.
Suboxone: Buprenorphine Plus Naloxone
Suboxone adds naloxone to buprenorphine. The Suboxone sublingual film comes in four strengths, from 2 mg of buprenorphine with 0.5 mg of naloxone up to 12 mg with 3 mg [1]. Generic films and tablets with the same two medications are also available, and pharmacies often fill these FDA-approved medications as a generic prescription.
Naloxone is an opioid antagonist, the same drug used to reverse overdoses. In Suboxone, it is there as a safeguard against misuse rather than as an active part of treatment. Our guide to how Suboxone works explains how the two ingredients work together.
Comparing Subutex and Suboxone: Key Differences
In a Subutex vs Suboxone comparison, the two are more alike than different. The table below sets out the key differences.
| Feature | Subutex (buprenorphine only) | Suboxone (buprenorphine and naloxone) |
|---|---|---|
| Active ingredient | Buprenorphine | Buprenorphine and naloxone |
| Form | Sublingual tablet (generic today) | Sublingual film or tablet |
| Brand status in the U.S. | Brand discontinued in 2011 | Brand and generics available |
| Main purpose of the extra ingredient | None | Naloxone discourages injection |
| Typical use | Specific cases, such as some pregnancies | The more common first choice |
What the Naloxone Component Does
When Suboxone dissolves under the tongue as prescribed, naloxone is absorbed only in small amounts, so it has little effect. If someone dependent on opioids dissolves and injects it, the naloxone becomes active and can cause sudden withdrawal. That makes injecting Suboxone unpleasant, which is the whole reason the naloxone is there.
Naloxone is intended mainly to deter injection; it does not make misuse impossible. When either product is taken as directed, buprenorphine drives its effects. Questions about does Suboxone get you high therefore apply to both, though absorption and individual responses can differ.
Is Subutex Stronger Than Suboxone?
Subutex is not inherently stronger than Suboxone: both rely on buprenorphine. However, tablets and films can differ in absorption even at the same labeled dose. The FDA label recommends monitoring and possible dose adjustments when switching products [1]. Do not switch forms or adjust the dose on your own.
Why Was Subutex Discontinued?
In September 2011, the maker of Subutex announced it was discontinuing distribution and sale of Subutex tablets in the United States [2]. The company said it believed the buprenorphine-only product carried a greater risk of misuse, abuse, and diversion than the combination product.
Not everyone agreed with that reasoning about misuse risk. A 2013 letter in a peer-reviewed journal argued that the evidence for lower abuse potential with the naloxone combination was weaker than claimed. Whatever the debate, generic buprenorphine remained available after the brand name Subutex ended, so the medicine itself never left the market.
When Is Buprenorphine Alone Prescribed Instead of Suboxone?
Buprenorphine-only medicine is less common today, but prescribers still choose it in some cases. Healthcare providers base the decision on medical history, not on which product someone prefers, and they review liver disease, pregnancy, and other medications first.
During Pregnancy
Buprenorphine alone has traditionally been preferred during pregnancy to avoid fetal naloxone exposure. A large 2024 observational study found similar, and for some outcomes more favorable, results with buprenorphine and naloxone compared with buprenorphine alone [3]. These findings support both as options to discuss with the prenatal and addiction care teams.
Because the study used health records rather than random assignment, it cannot rule out all differences between the groups. Neither formulation removes the possibility of newborn opioid withdrawal. Pregnancy care teams individualize treatment; do not stop or switch a stable medicine without their guidance.
Naloxone Allergy or Side Effects
A small number of people cannot tolerate naloxone because of an allergy or side effects they link to it. For them, buprenorphine based treatment without naloxone offers the same benefits, because the medication works on the same receptors.
In these cases, the prescriber may watch the person more closely, since a buprenorphine-only product lacks the injection deterrent against drug abuse. Misuse raises the risks described in our chapter on can you overdose on Suboxone. Treatment still pairs the medicine with counseling and regular check-ins, as in any comprehensive treatment program.
How Both Medicines Fit Into Opioid Addiction Treatment
Both products deliver buprenorphine, but initiation plans can differ. Standard induction generally waits for objective withdrawal signs to reduce precipitated-withdrawal risk. For people dependent on methadone or other long-acting opioids, the Suboxone label recommends buprenorphine-only induction initially [1]. A prescriber chooses the formulation and timing.
That withdrawal risk is why the prescriber, not the patient, sets the treatment plan for the first days. In a medication-assisted treatment program, either medicine is then paired with counseling as part of the treatment process, with the goal of reducing illicit opioid use over time.
Both carry the same safety warnings. Mixing either one with alcohol, benzodiazepines, or other sedatives raises the risk of dangerous breathing problems and opioid overdose. In January 2022, the FDA also warned about dental problems with buprenorphine medicines that dissolve in the mouth, a warning that applies to both [4].
Common side effects are similar, too, including headache, nausea, constipation, and trouble sleeping. Both medicines can cause physical dependence, so prescribers lower the dose gradually rather than stopping either one suddenly.
People sometimes ask which one is better to treat pain, and the short answer is that neither is approved for it. There is a full breakdown in our post on Suboxone and pain management here.
Subutex vs. Suboxone: Frequently Asked Questions
What’s the Difference Between Subutex and Suboxone?
Subutex contains only buprenorphine, while Suboxone combines buprenorphine with naloxone. Both treat opioid use disorder by easing withdrawal and cravings, and the naloxone in Suboxone does little when taken under the tongue but can trigger withdrawal if the medicine is injected. The Subutex brand ended in 2011, though generic buprenorphine-only tablets remain available.
Why Would a Doctor Prescribe Subutex Instead of Suboxone?
A prescriber may choose buprenorphine alone for someone who cannot tolerate naloxone, or in some pregnancies, although newer research supports the combination product during pregnancy too. The choice depends on medical history and how closely the person can be monitored. Generic buprenorphine-only tablets are what pharmacies fill for these prescriptions today.
Is Subutex Stronger Than Suboxone?
Neither product is inherently stronger because both use buprenorphine. Naloxone usually has little effect when Suboxone is taken as directed. However, films and tablets can differ in absorption at the same labeled dose. Any switch should be supervised so the prescriber can monitor symptoms and adjust treatment if needed.
Choosing the Right Buprenorphine Treatment
The best medicine is the one that fits your health, your history, and your recovery process. Many treatment programs that treat addiction with buprenorphine offer either form, and choosing Suboxone treatment or a buprenorphine-only medicine is part of the care plan rather than a separate decision. If you are in Broward County and want to talk through buprenorphine options with a care team, Simple Path Recovery’s admissions team can explain the next steps.
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
Sources
- U.S. Food and Drug Administration. SUBOXONE (buprenorphine and naloxone) sublingual film, prescribing information. Revised December 2025. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022410s057lbl.pdf
- Newman RG, Gevertz SG. Comment on “A Comparison of Buprenorphine + Naloxone to Buprenorphine and Methadone in the Treatment of Opioid Dependence during Pregnancy.” Substance Abuse: Research and Treatment. 2013;7:107 to 108. https://pmc.ncbi.nlm.nih.gov/articles/PMC3668890/
- Straub L, Bateman BT, Hernández-Díaz S, et al. Comparative Safety of In Utero Exposure to Buprenorphine Combined With Naloxone vs Buprenorphine Alone. JAMA. 2024;332(10):805-816. https://jamanetwork.com/journals/jama/fullarticle/2822178
- U.S. Food and Drug Administration. FDA warns about dental problems with buprenorphine medicines dissolved in the mouth to treat opioid use disorder and pain. January 12, 2022. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-dental-problems-buprenorphine-medicines-dissolved-mouth-treat-opioid-use-disorder
