Subutex treatment information

Subutex is a drug used to treat opioid addiction by blocking withdrawal symptoms and reducing cravings caused by stopping other opioids, such as heroin or fentanyl and prescription painkillers like Percocet and Vicodin.

Originally prescribed for pain relief, Subutex is a partial opioid antagonist, which binds to opioid receptors in the brain to reduce pain. Unlike full opioids, Subutex does not induce a euphoric state or “high” in its users. Consequently, it helps treat opioid addiction in several ways:

• Block withdrawal symptoms
• Stabilize the brain
• Reduce cravings
• Prevent relapse
• Promote long-term recovery

Together with behavioral and psychological counseling, this makes Subutex, like other accepted forms of MAT, an effective treatment for opioid addiction.

Suboxone and Subutex are both buprenorphine-based. The real difference is that Suboxone consists of both buprenorphine (80%) and naloxone (20%), while Subutex consists of buprenorphine alone. The function of naloxone is to inhibit the effects of opioids. If, for instance, someone tried to inject suboxone, the naloxone would induce a state of immediate withdrawal.

When either is taken under medical supervision, the buprenorphine in both works equally well in treating opioid addiction.

One consideration which separates the one from the other is the potential for abuse, with the naloxone in suboxone discouraging it to a greater degree (given its adverse effects). This suggests that Suboxone could be preferable to Subutex for severe opioid addiction or for patients seeking MAT after a relapse.

Subutex is preferable, however, for patients who cannot tolerate the presence of naloxone, making it a useful maintenance alternative to Suboxone.

Like any medication, Subutex has the potential for some side effects, including:

• Constipation
• Nausea
• Diarrhea
• Vomiting
• Headache
• Sweating

Note that not all or any of these side effects may occur, and need not require immediate medical attention. When they do arise, they may very well be temporary, as the body adjusts to the medication. The healthcare professionals at an MAT clinic could also help prevent or reduce these side effects.

Pregnant women with opioid addictions receive MAT during their pregnancy in order to reduce risks of opioid abuse and withdrawal as well as promoting pre- and post-natal care to both mothers and infants. After birth, the newborn babies are medically tapered off. Methadone and Subutex are two of the most widely used forms of maintenance during pregnancy, considered safe for the pregnant mothers.

Less is known about the safety of Subutex for the baby. However, a study conducted by the NIH found that while Methadone and Subutex each generally favored similar outcomes for pregnant women, Subutex saw a lower level of withdrawal symptoms in infants.

Another recent NIH study suggests that the low levels of buprenorphine found in breastmilk make it safe to breastfeed while new mothers are still taking Subutex for maintenance.

Subutex is typically dosed sublingually (under the tongue) in increments and decrements of 2 mg – 4 mg. The main consideration is dosing Subutex at a level that adequately suppresses the withdrawal symptoms it is employed to counteract. The recommended daily dose is 16 mg, with no evidence of the efficacy of more than 24 mg a day.

The effects of Subutex last for 24 hours. For most people, after completely stopping Subutex, no trace will be left in the body after five to eight days. For people with compromised liver health, it could take between seven and 14 days for Subutex to leave the body altogether.

Suddenly stopping Subutex after a prolonged period of use can precipitate withdrawal symptoms. These are similar to opioid withdrawals in general, with physical symptoms involving vomiting, nausea and diarrhea, and psychological symptoms including irritability, anxiety and insomnia, among others. But because Subutex is less potent than other opioids, and typically taken in smaller amounts, withdrawal is not usually so severe.

A medically monitored detox can help safely and comfortably manage withdrawal symptoms, as can a gradual taper schedule overseen by a treatment professional. Behavioral and emotional counseling, available through inpatient and outpatient treatment, will further facilitate the recovery process following detox and withdrawal.