Subutex detox can refer to the use of subutex as part of an opioid treatment program or it can refer to a detoxification program for the drug itself. Subutex is generally used at the beginning of treatment and works by preventing the withdrawal symptoms that occur when individuals stop taking opiates. These include anxiety, cravings, tremors, hallucinations, irritability, and flu-like symptoms. Unfortunately, the drug itself can be addictive so the individual might have to go through a second detox. Studies show that subutex is a very effective treatment for opioid addiction with withdrawal from it generally being much less severe. Individuals are usually able to function normally during detoxification.
Subutex works by binding to receptors in the brain and body. It is one of two buprenorphine products marketed today. Unlike its sister product, suboxone which is a combination product that contains naloxone, it is a mono therapy product containing only buprenorphine. Both subutex and suboxone are commonly prescribed for opioid drug dependency. Buprenorphine was first classified as a schedule V intravenous analgesic and was marketed in the 1980’s under the name Buprenex. Because of its addictive nature, side effects and potential for abuse buprenorphine was reclassified as a schedule III narcotic. In October 2002, it was approved by the Federal Drug Administration (FDA) for use in both detoxification and long term treatment programs for opioid addiction. Unfortunately, the drug itself can be addictive.
Subutex is prescribed as tablets that are taken sublingually or under the tongue. The replacement medication works as a partial agonist meaning its effects and potential for abuse and dependency are less than those of full agonists like methodone and heroine. It is used in medically supervised withdrawal for individuals with addictions to such opioids as lortabs, oxycontin, morphine, heroine, and others. It has several properties that make it ideal for use in detox programs. One is that individuals are unlikely to overdose on subutex alone because of what is called the “ceiling effect”. The product has increased effects up to about 32mg but beyond that there aren’t any additional effects so users can’t get higher by using more. This makes overdose and death using subutex alone is unlikely. Overdose and death can occur, however, when subutex is used with other substances like benzodiazepines, alcohol, and antidepressants. Subutex is also very dangerous if it is injected.
Detoxification using subutex has three basic phases. The first phase, called the induction phase, generally occurs after the individual has been without opioids for twelve to twenty-four hours and has early withdrawal symptoms. During this phase, the individual is monitored in a physician’s office and the dosage level determined. The second phase, called the stabilization phase, occurs when the individual has stopped other opiate drug use and no longer has cravings or suffers other side-effects from discontinued use. The individual continues to take subutex during this phase. The final phase is called the maintenance phase. This occurs when the individual is doing well and is taking a steady dosage of subutex. This phase can last a very short period of time or indefinitely.
Individuals taking subutex should be carefully monitored as they are weaned from the drug. Dosage levels should be tapered gradually during detoxification in what some providers call a step-down program and never “cold-turkey” unless the individual is in a rehab setting. Overall, subutex is a safe, effective pharmacological treatment for opioid addiction. It does not impair cognitive or psychomotor functions and there is little chance for overdose. Combined with behavioral therapy which includes individual and group counseling, individuals can overcome their addiction tp opiates and remain drug free.