Many individuals who have a dependence on opioids are sometimes prescribed Subutex (buprenorphine) to treat their addiction, but this drug itself also has some potential for abuse. While symptoms do vary in intensity and duration, regarding buprenorphine withdrawal, it’s helpful to know what, on average, a person can expect. Subutex is the brand name for buprenorphine, which is a partial opioid agonist. As such, the drug’s activation of opioid receptors in the brain and central nervous system (CNS) is minimal compared to full opioid agonists, such as heroin, fentanyl, and hydrocodone. Subutex is administered sublingually (placed under the tongue), where they then dissolve. When a full opioid agonist binds to a receptor, it activates the receptor to the fullest amount possible and induces euphoria and pain relief rapidly. This mechanism renders full opioid agonists effective but also very addictive. A partial opioid agonist, such as buprenorphine, does not work in exactly the same way. Opioid receptors are only minimally activated, so all effects are reduced. As a result, the euphoria is not as profound as that associated with heroin. A person may not experience as much pain relief, and the time of onset is significantly more gradual. This limitation of effects is purely by design. Because Subutex is a partial opioid agonist, this reduces the risk of being abused in the same manner in which full opioid agonists often are. This limitation is also the reason why it is used to treat opioid addiction. Moreover, Subutex facilitates a switch to a less addictive opioid, while still satisfying a person’s craving for opioids without the use of more potent substances, such as heroin. Another benefit is that physical and psychological withdrawal symptoms that can occur upon discontinuation of use are not as intense as they would be with full opioid agonists. Thus, cravings for buprenorphine will likely be easier to manage.
Subutex vs. Suboxone
Another brand name medication that includes buprenorphine is Suboxone, which contains a combination of buprenorphine and naloxone. Naloxone is an opioid antagonist, meaning that it completely blocks receptors by preventing other opioids from attaching using a method known as competitive binding. As noted, however, when buprenorphine is used by itself, it still has the potential for abuse. This drug has been misused both by legitimate patients and those who do so for recreational purposes. People have experienced overdoses as a result of misusing Subutex, such as by dissolving the film strips in water and then injecting the solution into veins. In doing so, the digestive system is bypassed, and the opioid is sent directly into the bloodstream. Indeed, some medications used to treat opioid addiction can have a dark side. Many who have been prescribed them for this purpose misuse them, believing that it is safer than abusing the other drugs in which they received treatment. While it’s true that when used as directed, buprenorphine is most certainly safer than heroin or fentanyl, but when misused, it still has the potential for addiction and overdose.
Subutex Withdrawal: Timeline and Effects
As an opioid, buprenorphine can induce withdrawal symptoms, not unlike those of heroin and other more potent opioids. In general, however, symptoms tend to be significantly milder in nature. These may include the following:
- Runny nose and teary eyes
- Fever, sweats, or chills
- Body aches and pain
- Sleep disturbances such as insomnia
- Mood swings
During buprenorphine withdrawal, the first symptoms are usually not encountered until after about 30 hours of the last dose. This is a much longer time to onset when compared to 6-12 hours for heroin or oxycodone. At this time, people will typically experience muscle pain, teary eyes, runny nose, and other flu-like symptoms. Psychological symptoms can include agitation, sleep disturbances, depression, and anxiety. The next set of symptoms will have manifested by around three days into withdrawal and can include nausea, diarrhea and vomiting, stomach cramps, profound depression, as well as intense cravings for more buprenorphine or other opioids. Physical withdrawal symptoms for buprenorphine should subside after about one week. However, psychological symptoms can endure for much longer, often for weeks or possibly months. It is during this time that people are at a high risk of experiencing intense cravings for buprenorphine or opioids, and without further treatment, relapse is an unfortunate possibility.
For this reason, it is vital that people seek the help of a professional addiction treatment center to address withdrawal symptoms, receive support, and identify the underlying causes for the continued drug abuse. Moreover, completion of the acute withdrawal process does not necessarily indicate a person will experience prolonged success at recovery. People with opioid addictions should undergo long-term therapy and counseling to address the mental health effects of opioid abuse. Treatment for Subutex withdrawal can be performed in an inpatient or outpatient setting. Which option is most appropriate will largely depend upon the severity of drug abuse or addiction. If the person is using buprenorphine to treat a pre-existing opioid addiction, the health provider might recommend a tapering schedule in which they are gradually weaned off buprenorphine. In doing so, the person’s body is given time to adjust to the reduced opioid presence. Conversely, those who were abusing buprenorphine for non-medical or recreational purposes might be advised to undergo a full detox. In either case, naltrexone, a non-opioid treatment for opioid dependence, may be administered once the body is free of opioids to help reduce cravings and facilitate this process.
Getting Treatment for Opioid Addiction
As the treatment process continues, patients will be encouraged to meet with more addiction treatment providers to further address their mental and emotional health as well as other factors that contributed to their addiction. Such treatment programs have been clinically proven to be extremely beneficial for patients in promoting sustainable, long-term recovery. Without comprehensive treatment, the chance of a person reverting back to the abuse of buprenorphine or other opioids increases significantly. Rehab can be challenging, but the support it provides can help people control their addictive behaviors for years to come. Harmony Recovery Center offers different forms of support to help our patients continue the challenging work required for recovery. We teach people how to use healthy coping mechanisms that can effectively prevent relapse and help them to identify triggers and make better decisions in their lives. Our comprehensive treatment programs are customized to meet each individuals’ needs and goals, and include, but are not limited to, the following:
- Partial hospitalization programs
- Intensive and regular outpatient programs
- Cognitive-behavioral therapy
- Individual and family counseling
- Peer support groups
- Art, music, and adventure therapy
- Substance abuse education
- Health and wellness programs
- Medication-assisted treatment
- Aftercare planning
This multifaceted approach may seem overwhelming to some, but it is critical to understand it’s long-term value. The use of a variety of approaches and a long-term plan for ongoing aftercare support can help individuals learn how to handle stress better while they focus on their recovery. Contact us today if you are ready to reclaim your life and break free from the cycle of addiction, once and for all! We are dedicated to providing our clients with the tools and support they need to sustain long-term recovery, health, and wellness!