Many people with a dependence on opioids are prescribed Subutex to address their addiction, but the medication itself has some potential for dependence and possible misuse. While withdrawal symptoms tend to vary in severity and duration, it’s helpful to know what a person might expect.
Subutex is the brand name for buprenorphine, a partial opioid agonist. As such, the medication’s activation of opioid receptors in the brain and CNS (central nervous system) is minimal compared to full opioid agonists, such as heroin, fentanyl, and oxycodone. Subutex tablets are administered sublingually under the tongue where they dissolve.
When an opioid agonist binds to a receptor, it activates the receptor fully and produces feelings of euphoria and pain relief rapidly. This mechanism makes full opioid agonists effective at their purpose but also very addictive.
A partial opioid agonist, such as buprenorphine, however, does not act in the brain exactly the same way. Opioid receptors are only minimally activated, and therefore all effects are reduced. For this reason, the euphoria is not as profound as that which is commonly associated with heroin or other powerful full agonist opioids. An individual may not experience as much pain relief, and the time of onset takes longer and is more gradual.
This limitation is entirely by design. Because Subutex is a partial opioid agonist, the risk of abuse is reduced compared to full opioid agonists. This ceiling of effects is also the reason why it can be used to address opioid addiction effectively.
Moreover, Subutex offers a convenient replacement as a less addictive opioid, while still satisfying an individual’s craving for more potent opioids. Another benefit is that physical and mental withdrawal symptoms that may occur upon cessation of use are not as intense as they could be with full opioid agonists. Therefore cravings for buprenorphine will likely be easier to manage.
Subutex vs. Suboxone
Another buprenorphine medication is Suboxone. It also includes naloxone, an opioid antagonist, meaning that it completely blocks receptors by keeping other opioids from attaching using a method referred to as competitive binding.
However, as noted, when buprenorphine is used alone, it still has some potential for misuse. This medication has been abused by legitimate patients and those who do so for recreational or non-medical purposes. Some people have experienced overdoses due to Subutex’s misuse, specifically by dissolving the film strips in water and administering the solution intravenously. In doing so, the digestive system and liver filtering are bypassed, and the opioid is transmitted directly into the user’s bloodstream.
Moreover, some drugs used to treat opioid dependence can have a darker side. Many people who have been prescribed them for this reason abuse them, erroneously believing that it is somewhat safer than abusing the other drugs in which they are receiving treatment. While it’s true that buprenorphine is almost certainly safer than heroin or fentanyl when used as directed, but when misused, it still has a potential for addiction and even overdose.
Subutex Withdrawal – Timeline and Effects
As an opioid, buprenorphine dependence can lead to withdrawal symptoms upon discontinuation of use. These may be comparable to those associated with heroin, oxycodone, and other more potent opioids. In general, however, symptoms tend to be much milder in nature and may include the following:
- Nausea and vomiting
- Runny nose
- Teary eyes
- Fever, sweats, and chills
- Body aches and pain
- Sleep disturbances
- Mood swings
During buprenorphine withdrawal, initial symptoms are usually not experienced until after about 30 hours following the last dose. This is a much longer onset time when compared to 6-12 hours for oxycodone or heroin. At this time, people will often experience muscle pain, teariness, runny nose, and other flu-like symptoms. Psycho-emotional symptoms can include anxiety, agitation, depression, and sleep disturbances.
The next set of symptoms will onset by around 72 hours into withdrawal. They may include nausea and vomiting, diarrhea, stomach pain, profound depression, and intense cravings for more buprenorphine or other opioids.
Physical withdrawal symptoms for buprenorphine should begin to wane after about one week. However, psycho-emotional symptoms can persist for much longer, often for weeks or even months. During this time, individuals are at a high risk of continued cravings and relapse and may require further treatment.
For this reason, people must seek the help of a specialized addiction treatment center to address withdrawal symptoms, receive continuous support, and identify the underlying root causes for the continued drug abuse. Moreover, completing the acute withdrawal process does not necessarily indicate an individual will experience long-term success at recovery. People with opioid addictions should undergo comprehensive therapy and counseling for as long as needed to address the mental and emotional effects of opioid dependence.
Treatment for Subutex withdrawal can be conducted in an inpatient or outpatient setting. Which option is appropriate will depend upon the severity of drug dependence or addiction. If the person uses buprenorphine to treat a pre-existing opioid addiction, a health professional or addiction specialist might recommend a tapering schedule in which they are gradually weaned off buprenorphine. In doing this, the person’s body is given time to readjust to the reduced opioid presence.
Conversely, those misusing buprenorphine for non-medical or recreational purposes might be advised to undergo medical detox. In either case, naltrexone, another treatment for opioid dependence, may be administered when the body has been cleared of opioids to help minimize cravings and facilitate the detoxification process.
Getting Treatment for Opioid Addiction
As the treatment process continues, individuals will be encouraged to meet with more addiction treatment providers to treat further their mental and emotional health and other factors contributing to their addiction. Such treatment programs have been clinically-proven to be beneficial for patients in promoting sustainable, long-lasting recovery.
Without comprehensive treatment, the risk of an individual reverting back to the abuse of buprenorphine or other opioids increases significantly. Rehab can be challenging but can offer hope for those seeking to control their addictive behaviors for years to come through intensive treatment and ongoing support.
Just Believe Detox and Just Believe Recovery centers offer several clinically-proven therapies and services to help those we treat to continue the extensive work required for recovery. We teach those we treat how to use healthy coping mechanisms to effectively prevent relapse and help them identify triggers and make better choices in their lives.
Our comprehensive treatment programs are tailored to meet each person’s needs and goals and include the following:
- Partial hospitalization programs
- Residential programs
- Individual and family counseling
- Group support
- Experiential therapies
- Substance abuse education
- Health and wellness programs
- Relapse prevention
- Aftercare planning
This multifaceted approach may seem overwhelming to many, but it is vital to understand it’s long-term value. The use of various methods and a long-term plan for ongoing aftercare can help individuals learn how to handle stress better while focusing on their recovery.