“Suboxone® remains highly available for illicit use throughout OSAM regions. Street availability for the drug has increased in half of the OSAM regions. Participants and community professionals continued to report that the most available type of Suboxone® is the sublingual filmstrip form (aka “strips”). In many regions, participants noted filmstrips as the only available form of Suboxone® on the streets. However, participants in Akron-Canton indicated street availability of Subutex® pills, which they said are preferred for illicit use as this drug does not contain naloxone (opiate overdose reversal medication). These participants reported that prescriptions for Subutex® are generally limited to pregnant women.

“In regions with an increase in street availability of Suboxone® during the past six months, respondents generally attributed increased availability to an increase in heroin use and thus an increase in the number of users seeking prescriptions for the drug. Reportedly, many users will obtain a prescription and sell or trade all or part of their prescription for heroin or other opiates. Treatment providers discussed that Suboxone® is not a primary drug of choice among users; the drug is used illicitly primarily as a substitute or supplement to heroin use. Users rely on the drug to stave off withdrawal symptoms between heroin purchases.

“Respondents in the Akron-Canton and Columbus regions reported an increase in “cash and carry” clinics in those regions as fueling the street economy for the drug. A law enforcement officer in the Youngstown region stated that there are people trafficking Suboxone® in that area. In regions where there was no consensus as to availability change during the past six months, several respondents believed street availability has decreased as more users are being prescribed Vivitrol® injections over Suboxone®, thus reducing street availability for Suboxone®. Current street jargon includes a few names for Suboxone®. Participants continued to report that street names refer to the color, shape or shortened version of the drug name.

“Throughout OSAM regions, reports of current street prices remained variable among participants with experience buying the drug. Generally, Suboxone® 8 mg filmstrips sell for approximately $15-20. However, in the Cleveland and Cincinnati regions, a Suboxone® 8 mg pill sells for $10-15, while in the Akron-Canton and Columbus regions, it sells for as high as $25-30. Participants noted that users pay more if desperate to avoid “dope sickness” associated with heroin or prescription opioid withdrawal. Some participants also reported higher prices for Suboxone® sold in jails and prisons.

“In addition to obtaining Suboxone® on the street from dealers, participants continued to report most often securing the drug for illicit use from doctors, treatment centers, Suboxone® clinics and other users with prescriptions. Participants reported that the most common route of administration for illicit use of Suboxone® remains sublingual, followed by intravenous injection (aka “shooting”). Participants in Toledo discussed the attraction to shooting Suboxone® as using less of the drug, feeling the drug’s effect quicker and avoiding the “awful” taste of orally consuming the drug.

“Participants and community professionals continued to describe typical illicit users of Suboxone® as individuals addicted to heroin and other opiates who substitute with Suboxone® when other opiates are unavailable as a way to self-medicate for withdrawal. Reportedly, few other drugs are used in combination with Suboxone®, as the drug is mostly used to avoid withdrawal symptoms. However, some users reported using Suboxone® in combination with marijuana simply due to the universality of marijuana use, while other users reported taking Suboxone® in conjunction with other drugs to intensify the effect of the other drugs.”