Subutex: Uses, Side Effects & How it Can Help

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Subutex is a branded version of buprenorphine used to treat opioid use disorder.

Approved by the FDA (U.S. Food and Drug Administration) in 2002, Subutex medication was discontinued in 2011.

Subutex is still available in generic form as buprenorphine.

MAT (medication-assisted treatment) is a research-based treatment protocol involving pharmacological interventions delivered in combination with behavioral interventions like psychotherapy (talk therapy) and counseling.

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What is Subutex?

Buprenorphine (Subutex) is commonly administered during MAT to help people discontinue or moderate the use of prescription opioid painkillers, opiates like morphine, and the illicit semi-synthetic opioid heroin. 

The Subutex pill was approved by the FDA for clinical use in October 2002. Medications like buprenorphine provide a holistic approach to treating opioid dependency when delivered alongside behavioral interventions. 

If Subutex is taken precisely as directed, the medication is safe and effective. 

Buprenorphine brand names include: 

  • Subutex
  • Suboxone
  • Buprenex

Buprenorphine is an antagonist at the kappa opioid receptor and a partial agonist at the mu opioid receptor. Resultantly, the medication can displace morphine, methadone, and other full opioid agonists from the mu receptor. 

The partial agonist properties of buprenorphine generate the following desirable properties from a clinical standpoint: 

  • Low potential for abuse.
  • Low level of physical dependence.
  • Ceiling effect when taken in higher doses.
  • Greater safety in opioid overdose than full opioid agonists.

As a partial opioid agonist, buprenorphine occupies a midpoint between full opioid agonists (methadone) and opioid antagonists (naltrexone). 

Methadone has been used since the 1950s to treat opiate addiction, but the medication must be delivered in a structured clinical setting. Buprenorphine, by contrast, is the first medication permitted to be dispensed or prescribed in physician offices. Per the Drug Addiction Treatment Act of 2000, qualified physicians in the United States can prescribe buprenorphine in various settings, widening access to treatment. 

OTPs – opioid treatment programs certified by SAMHSA (Substance Abuse and Mental Health Services Administration) – may offer buprenorphine, but only in a dispensing capacity. 

Subutex, like all medications used in MAT, is always most effective as part of an overarching treatment plan that includes both counseling and psychotherapy. 

How Long Does Subutex Stay in Your System?

The effects of Subutex (buprenorphine) last for roughly 24 hours. 

After a single dose of Subutex, all traces of the drug should be eliminated after between five to eight days in healthy individuals. Those with severe liver disease can expect Subutex to linger in the system for between seven and fourteen days. 

Subutex has an elimination half-life of between 24 and 42 hours. It takes from four to five half-lives before a drug is completely eliminated from the system.

Subutex Side Effects

The side effects of buprenorphine are similar to those of opioids. These can include: 

  • Irritability
  • Distress
  • Nausea
  • Vomiting
  • Constipation
  • Cramps and muscle aches
  • Insomnia
  • Fever
  • Cravings for opioids

Subutex Withdrawal

Subutex can lead to the development of physical dependence, even when used legitimately. Dependence on a drug means you will experience withdrawal symptoms in its absence. 

Withdrawal symptoms will vary in onset, duration, and severity depending on how long you have been taking Subutex and how much of the medication you have been taking. 

Most physical withdrawal symptoms – more on these below – will subside within a month. Psychological symptoms may persist for longer. 

During the first week of withdrawal, uncomfortable physical withdrawal symptoms will present as your body struggles to accustom itself to the absence of buprenorphine. These symptoms will subside after a week or so, with depression the most pronounced residual symptom, along with mood swings and insomnia.

Subutex Withdrawal Symptoms 

Subutex withdrawal symptoms may include: 

  • Nausea and vomiting
  • Indigestion
  • Digestive upsets
  • Headache
  • Body aches
  • Muscle aches
  • Chills
  • Fever
  • Sweating
  • Lethargy
  • Insomnia
  • Irritability
  • Agitation
  • Depression
  • Anxiety
  • Cravings
  • Difficulty with focus

Timeline

The duration and severity of Subutex withdrawal will differ from person to person. Here is an approximate timeline for buprenorphine withdrawal: 

  • 1 to 3 days after last dose of Subutex: The most common symptoms during the initial three days of Subutex withdrawal include restlessness, sweating, nausea, diarrhea, dilated pupils, and watery eyes.
  • 4 to 7 days after last dose of Subutex: Mood swings, depression, and anxiety often manifest during the first week of Subutex detox, in addition to body aches, abdominal cramps, and insomnia.
  • 7 to 14 days after last dose of Subutex: Most of the severe withdrawal symptoms will subside, although feelings of irritability and depression may linger. You may also experience body aches, abdominal cramps, and intense cravings for Subutex.
  • 3 weeks after last dose of Subutex: Psychological symptoms like depression, cravings, and mood swings may linger for weeks after your last dose of Subutex, but these should subside.

How Subutex Can Help

Buprenorphine treatment for opioid dependency is most effective in the following scenarios: 

  • You have been diagnosed with opioid use disorder.
  • You are willing to use buprenorphine exactly and only as prescribed.
  • There are no underlying health conflicts contraindicating the use of buprenorphine.
  • You have reviewed all other treatment options.

Buprenorphine treatment unfolds over three distinct phases: 

  1. Induction Phase: The startup phase of buprenorphine treatment takes place in the office of a qualified physician’s office. Alternatively, the induction phase can be performed at a certified OTP with approved buprenorphine products. Once you have abstained from opioids for 12 to 24 hours, buprenorphine can be first administered. If you are not in the early stages of opioid withdrawal and you take buprenorphine, this can trigger acute withdrawal. The same applies if you have opioids in your bloodstream when taking buprenorphine.
  2. Stabilization Phase: When you have discontinued or dramatically reduced your misuse of opioids, the dose of buprenorphine will likely need adjusting. During the stabilization phase, dosing often drops to alternate days from daily dosing.
  3. Maintenance Phase: The length of the maintenance phase of buprenorphine treatment is tailored according to the individual. This phase is characterized by an ongoing positive response to a steady dose of buprenorphine.

 

To underscore, Subutex therapy is always most beneficial when supplemented with counseling and talk therapy.

Medication-Assisted Treatment at California Detox

Here at California Detox in Orange County, we specialize in the outpatient treatment of addictions, enabling you to connect with flexible and affordable care for the following conditions: 

  • Drug addiction (substance use disorder)
  • Alcoholism (alcohol use disorder)
  • Mental health disorders
  • Co-occurring disorders

If you are addicted to alcohol or opioids, MAT can be a vital component of treatment. At CA Detox, medication-assisted treatment is delivered together with the following therapies: 

  • Individual counseling
  • Group counseling
  • Psychotherapy (CBT and DBT)
  • Family therapy
  • Holistic therapies

For those who require more structure and support than a traditional outpatient program provides, we also offer the following programs:

  • IOP (intensive outpatient program)
  • PHP (partial hospitalization program)

Take advantage of medication-assisted treatment in an outpatient setting by calling admissions today.

FAQs

Suboxone contains buprenorphine and naloxone, while Subutex only contains buprenorphine.
Buprenorphine is classified as a partial opioid agonist.

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