Singapore's Experience With Buprenorphine (Subutex)

Buprenorphine (Subutex) has been used to treat opioid dependency in the past 16 years. Subutex (or buprenorphine hydrochloride) was approved by the Singapore's Ministry of Health (MOH) in 2000 as a substitution treatment for opiate-dependent drug abusers within the framework of medical, social and psychological treatments. It was subsequently introduced into the Singapore market in 2002. In spite of the promise of improvement in the lives of addicts with medical care, a distinct trend of buprenorphine abuse has occurred. A cascade of events from 2002 to 2006 led to discontinuation of Subutex treatment programs in the country. In this paper, firstly reports on morbidity and mortality caused by Subutex IV abuse will be reviewed and secondly, the MOH response to the situation will be outlined and finally, implications of Singapore's experience with Subutex will be discussed.