When Dylann Roof, the suspect in the deadly shooting at the Emanuel AME Church in Charleston, was arrested last February on trespassing charges at a mall in Columbia, South Carolina, police said he was carrying a pack of thin orange strips, which he allegedly admitted were the oral version of the drug Suboxone.
CBS News correspondent Adriana Diaz reported that classmates alluded to Roof having a drug habit, describing him as a "pill popper" who "told racist jokes." As investigators piece together more information about Roof's background and past behavior, experts can shed some light on the drug he's accused of possessing.
Suboxone is the brand name of a narcotic that's considered milder than others drugs in its class, such as oxycontin, heroin and vicodin. It is prescribed as a step-down drug for the treatment of opiate and painkiller addictions. It comes in both pill form and thin film strips that dissolve on the tongue, the type Roof had, according to police.
Doctors and researchers in the field of addiction say that Suboxone been a helpful tool in fighting opiate addictions without the need to send patients to methadone clinics. It is sometimes called the "middle class methadone."
"While its safer than heroin or methadone if you take it as directed, if you don't it's as dangerous as any of these other drugs," Dr. Eric Wish, the Director of the Center for Substance Abuse Research at the University of Maryland, told CBS News.
In addicts, opioids can cause unpredictable mood swings, manipulative behaviors, lying, and an inability to meet responsibilities, according to The National Alliance of Advocates of Buprenorphine Treatment.
In a statement emailed to CBS News, Indivior Inc., the manufacturer of Suboxone, said, the drug is "safe and effective when taken as directed," and noted that "the use of SUBOXONE Film has not been associated with aggression in clinical studies or post-marketing experience." The company also extended its "deepest sympathies" to the victims of the Charleston shooting.
Suboxone is a hybrid composed of three parts of the opiate buprenorphine, which is considered milder and therefore safer than other opiates, and one part naloxone, an overdose antidote which makes users sick if they try to shoot it up with a syringe.
Suboxone was reclassified as a schedule III narcotic in 2002 and is supposed to be prescribed only by physicians who are treating fewer than 30 patients for opiate addiction. According to the American Society of Addiction Medicine, psychosocial therapy to accompany use of Suboxone is recommended.
But the black market is growing. Suboxone is on the list of the increasing numbers of prescription drugs available through "pill mills" or "diversion" -- distribution of excess drugs obtained through prescription to friends, relatives or paying customers.
"It's sold on the street to what are called weekend warriors," Dr. Terry Furst of John Jay College of Criminal Justice, told CBS News. Users are often "people in the early stages of experimentation with illicit drugs."
Furst, who has been studying the diversion of opioids including Suboxone to the street, added that many of the people who use Suboxone are already opiate dependent and for them it's a milder drug. But for those who have never been opiate dependent, the high can last up to 8 hours.
Other known side effects of the drug may be greater for those who use it recreationally and not for its intended purpose of opiate recovery. The most common reported side effects of the drug include flu-like symptoms, headaches, sweating, sleeping difficulties, nausea, and mood swings.
"People can look high, their pupils can become dilated, they can be look sleepier, they can be more irritable, more depressed," said Dr. Samuel A. Ball, CEO and President of CASAColumbia, an organization that researches substance abuse addiction.
Mixing the drug with common depressants such as alcohol or valium, which opiate users of all kinds are known to do, can remove the "ceiling effect" and increase those more extreme feelings of euphoria.
"What I kind of hear from patients is that, once someone becomes addicted to opioids and their usual medication is not available, they will kind of use whatever's they can to keep their high going," said Ball. "They may continue to use Suboxone just because someone in their neighborhood has it and there's a supply that's available and that's the easiest thing to get."
Law enforcement seizures of buprenorphine drugs, which include Suboxone and generics, has increased from 90 to 10,537 packages between 2003 and 2010, according to the latest report from National Forensic Laboratory Information System (NFLIS), which the DEA uses to monitor diversion.
"It may be a good drug, but the potential for misuse is there," said Wish. "We're not doing the work of monitoring and tracking to avoid the negative consequences."