Subutex Addiction: Risks and Treatment Options

Subutex, a medication containing buprenorphine, is widely used in the treatment of opioid dependence. While it has proven effective in helping individuals overcome addiction to stronger opioids, Subutex itself is addictive when misused. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2018, over 2 million people in the United States had an opioid use disorder related to prescription pain relievers, including medications like SubutexThe rise in Subutex addiction is a concerning trend amid the broader opioid epidemic.

There are risks when taking Subutex. These include developing a dependency on the drug, experiencing withdrawal symptoms, and potentially engaging in dangerous behaviors to obtain it. Misuse can lead to respiratory depression, especially when combined with other substances like alcohol or benzodiazepines, increasing the risk of overdose.

Treatment for Subutex addiction involves a combination of medication-assisted treatment (MAT) and behavioral therapies. MAT will include alternative medications like methadone or naltrexone, under medical supervision, to manage withdrawal symptoms and cravings. Behavioral therapies, such as cognitive-behavioral therapy (CBT) and counseling, are crucial for addressing the psychological aspects of addiction and supporting long-term recovery.

Despite its intended use in treating opioid addiction, Subutex itself has become a substance of misuse. The opioid epidemic, which has claimed over 500,000 lives from opioid overdoses between 1999 and 2019 according to the Centers for Disease Control and Prevention (CDC), has also seen a rise in the misuse of medications designed to combat it… Individuals may misuse Subutex for its euphoric effects, leading to dependence and addiction. The increased availability of Subutex through legitimate prescriptions has also contributed to its misuse, with some people diverting it for non-medical use. As addiction to Subutex grows, so does the need for targeted interventions to address this emerging facet of the opioid crisis.

What is Subutex?

Subutex is a brand name for a medication containing buprenorphine, a partial opioid agonist. It was first approved by the U.S. Food and Drug Administration (FDA) in 2002 for the treatment of opioid dependence. Buprenorphine was developed in the 1960s and has since become a critical component in medication-assisted treatment (MAT) for opioid addiction, offering a safer alternative to methadone.

Buprenorphine is primarily used to treat opioid dependence and addiction. It helps reduce cravings and withdrawal symptoms associated with opioid use disorder, making it easier for individuals to stop using opioids like heroin, fentanyl, and prescription painkillers. By partially activating opioid receptors in the brain, Subutex provides enough stimulation to prevent withdrawal without producing the full opioid effects, which helps lower the risk of misuse and addiction. The National Institute of Drug Abuse in 2023 found that buprenorphine is effective in reducing opioid use and increasing treatment retention. Patients on doses of 16 mg or more were 1.82 times more likely to stay in treatment than those on lower doses or placebo.

Subutex is available in sublingual tablets that are placed under the tongue to dissolve. The dosage varies based on the individual’s needs and the severity of their addiction. Typical starting doses range from 2 mg to 8 mg per day, with adjustments made based on the patient’s response to treatment. Maintenance doses generally range from 4 mg to 24 mg per day, administered once daily.

Other brand names and formulations that include buprenorphine for opioid dependence treatment include Suboxone (which combines buprenorphine with naloxone), Zubsolv, and Bunavail. These medications are part of the broader category of buprenorphine-based treatments used in managing opioid addiction.

What is The Addiction Potential of Subutex?

If misused, Subutex is addictive, though the risk is lower compared to full opioid agonists. According to the National Institute of Drug Abuse, a study conducted between 2016 and 2020, 59% of patients newly initiating buprenorphine treatment discontinued it within 180 days. The majority of these patients were aged 25 to 44 years, and most were male risk factors for addiction to Subutex include:

  • History of Substance Abuse: Individuals with a past of abusing drugs or alcohol are more susceptible to developing an addiction to Subutex.
  • Genetic Predisposition: Genetic factors can influence how a person responds to Subutex, increasing the likelihood of addiction.
  • Psychological Factors: Conditions such as stress, anxiety, and other mental health disorders can contribute to the risk of addiction.
  • Misuse of Subutex: Taking higher doses than prescribed or using it in unintended ways (e.g., injecting the tablets) heightens the potential for addiction.

However, when used correctly under medical supervision, Subutex is a valuable tool in treating opioid addiction with a relatively lower risk of dependence.

What are the Signs of Subutex Addiction?

Symptoms and Signs of Subutex Addiction

There are many physical and psychological signs of Subutex misuse. It is important to recognize these symptoms in order to get appropriate treatment in a timely manner. 

What are the Physical Signs of Subutex Addiction?

  • Drowsiness or Sedation: Excessive sleepiness or a state of deep calm and relaxation.
  • Respiratory Depression: Slow or shallow breathing, which can be life-threatening.
  • Constriction of Pupils: Noticeably small pupils, even in low light.
  • Nausea and Vomiting: Persistent feelings of nausea and episodes of vomiting.
  • Sweating: Unexplained excessive sweating.
  • Itching: Persistent itching without a clear cause.
  • Constipation: Ongoing difficulty in bowel movements.
  • Withdrawal Symptoms: Experiencing symptoms such as muscle aches, insomnia, irritability, and anxiety when not taking the drug.

What are the Psychological Signs of Subutex Addiction?

  • Cravings: Strong, uncontrollable urges to use Subutex.
  • Obsessive Thoughts: Constant thinking about the next dose or maintaining a supply.
  • Mood Swings: Rapid changes in mood, including irritability, depression, or euphoria.
  • Anxiety and Paranoia: Increased feelings of anxiety or suspicious thoughts.
  • Social Withdrawal: Isolating from friends and family, losing interest in activities once enjoyed.
  • Deceptive Behavior: Lying or being secretive about drug use, doctor shopping to get more prescriptions.

When Does Legitimate Use Cross into Addiction?

Legitimate use of Subutex crosses into addiction when the individual begins to misuse the medication, often characterized by:

  • Increasing Dosage: Taking higher doses than prescribed to achieve the desired effects.
  • Frequent Use: Using the medication more frequently than directed by a healthcare provider.
  • Non-Medical Use: Using Subutex in ways not intended, such as injecting or snorting the medication.
  • Compulsive Behavior: Feeling compelled to take Subutex despite negative consequences on health, relationships, and daily responsibilities.
  • Doctor Shopping: Visiting multiple doctors to obtain additional prescriptions.
  • Withdrawal Avoidance: Continuing to use Subutex to avoid withdrawal symptoms rather than for its intended purpose.

What are the Risks Associated with Subutex Addiction?

There are both short-term and long-term health risks of Subutex Addiction. Despite its intended use in treating opioid addiction, Subutex itself has become a substance of misuse. The opioid epidemic, responsible for over 70,000 opioid-related overdose deaths in 2021, has seen increased misuse of medications like Subutex according to the CDC in 2023. The accessibility of Subutex through legitimate prescriptions has contributed to its misuse, with some individuals using it recreationally or in higher doses than prescribed. 

The Dangers of Subutex Addiction

Short-term Health Risks:

  • Respiratory Depression: Subutex can slow breathing significantly, especially when taken in large doses or misused.
  • Drowsiness and Sedation: Excessive sleepiness can impair daily functioning and increase the risk of accidents.
  • Nausea and Vomiting: Common side effects that can lead to dehydration and electrolyte imbalances.
  • Constipation: Ongoing difficulty with bowel movements, which can cause discomfort and other gastrointestinal issues.

Long-term Health Risks:

  • Dependence and Tolerance: Prolonged use can lead to physical dependence and tolerance, requiring higher doses to achieve the same effect.
  • Liver Damage: Long-term use of buprenorphine can potentially lead to liver dysfunction or damage.
  • Hormonal Imbalances: Chronic use may affect the endocrine system, potentially leading to hormonal imbalances.
  • Cardiovascular Issues: There may be an increased risk of heart-related problems with prolonged abuse.

The Danger of Mixing Subutex with Other Substances:

Mixing Subutex with other substances is extremely dangerous and potentially fatal. Here is a list of the interactions of Subutex when combined with other substances:

  • Alcohol: Combining Subutex with alcohol can enhance the sedative effects, leading to severe respiratory depression, loss of consciousness, and even death.
  • Benzodiazepines: Using Subutex with benzodiazepines (e.g., Xanax, Valium) significantly increases the risk of respiratory failure and fatal overdose. The CDC reports that nearly 30% of opioid-related overdose deaths involve benzodiazepines.
  • Other Opioids: Mixing Subutex with other opioids will lead to compounded effects, resulting in profound sedation, respiratory arrest, and overdose.

What is The Impact of Subutex Addiction on Mental Health?

Subutex addiction has significant negative effects on mental health. Misuse of Subutex increases anxiety and depression, exacerbating existing mental health conditions or leading to the development of new ones. Chronic use of Subutex impairs cognitive functions such as memory, attention, and decision-making. This addiction often results in severe mood instability, causing episodes of irritability, aggression, or euphoria. Individuals struggling with Subutex addiction may withdraw from social interactions and activities they once enjoyed, leading to feelings of loneliness and depression. Additionally, the constant need to use Subutex will dominate thoughts and behaviors, creating a state of psychological dependence that makes it difficult to focus on other aspects of life.

What are the Treatment Options for Subutex Addiction?

Treating Subutex addiction involves a multi-faceted approach that includes medical intervention, behavioral therapies, and support systems. The goal is to help individuals achieve and maintain sobriety, manage withdrawal symptoms, and address the psychological aspects of addiction.

Detoxification: The First Step in Treating Subutex Addiction

Detoxification is often the initial phase of treatment for Subutex addiction. This process involves allowing the body to eliminate the drug while managing withdrawal symptoms under medical supervision. Withdrawal symptoms can include anxiety, irritability, muscle aches, nausea, and cravings. Proper medical management during detox can help alleviate these symptoms and reduce the risk of complications.

Inpatient vs. Outpatient Treatment Programs

Choosing between inpatient and outpatient treatment programs depends on the severity of the addiction and the individual’s specific needs. Inpatient programs provide a structured, supportive environment with 24/7 medical care, making them suitable for severe addictions or individuals at high risk of relapse. Outpatient programs offer more flexibility, allowing individuals to live at home while attending scheduled therapy sessions and medical appointments. This option is often ideal for those with milder addictions or strong support systems at home.

Medication-Assisted Treatment (MAT) for Opioid Addiction

Medication-Assisted Treatment (MAT) combines the use of medications with counseling and behavioral therapies to treat opioid addiction. For Subutex addiction, MAT will involve the use of alternative medications such as methadone, naltrexone, or another form of buprenorphine to manage withdrawal symptoms and reduce cravings. 

Behavioral Therapy for Subutex Addiction

Counseling and behavioral therapies, such as cognitive-behavioral therapy (CBT), help address the psychological aspects of addiction, teaching coping strategies and relapse prevention skills. MAT has been shown to improve treatment retention and reduce the risk of relapse and overdose. 

Addressing Co-occurring Disorders in Treatment

Many individuals with Subutex addiction also struggle with co-occurring mental health disorders, such as depression, anxiety, or PTSD. Addressing these co-occurring disorders is crucial for successful treatment. Integrated treatment approaches that address both the addiction and the mental health disorder simultaneously are more effective. This may include a combination of medication, counseling, and behavioral therapies tailored to the individual’s specific needs.

How Do I Maintain Recovery and Support for Subutex Addiction?

Successful recovery from Subutex addiction involves several key strategies. Developing a structured daily routine helps individuals stay focused and avoid triggers. Engaging in regular physical activity, maintaining a healthy diet, and practicing mindfulness or meditation can improve overall well-being and reduce stress. Setting realistic and achievable goals can also provide motivation and a sense of purpose during recovery.

Building a strong support network is essential for lasting sobriety. This network can include family, friends, therapists, and members of support groups. Open communication and trust within this network are crucial. It is also beneficial to seek out a sponsor or mentor who has experience with recovery and can provide guidance and support.

Preventing relapse involves ongoing commitment and vigilance. Continuing with therapy and support group meetings after formal treatment ends is crucial. Recognizing and avoiding triggers, such as certain environments or stressful situations, is important. Developing healthy coping mechanisms for dealing with stress and emotions can help maintain sobriety. Regularly reviewing and updating one’s recovery plan can ensure that it remains effective and relevant.

By implementing these strategies and maintaining a robust support network, individuals recovering from Subutex addiction can achieve and sustain long-term sobriety.

How Long Does Subutex Stay in Your System?

Subutex can be detected in urine for up to 3-4 days after the last dose. Blood tests can detect it for up to 24 hours, while saliva tests can detect it for 1-4 days. Hair tests can identify buprenorphine use for up to 90 days.

Can Subutex Affect Liver Function?

Long-term use of Subutex will lead to liver damage, especially at high doses. Regular liver function tests are recommended for individuals on prolonged Subutex therapy to monitor and prevent any liver-related issues.

What is The Ceiling Effect of Subutex?

The ceiling effect refers to the point at which increasing the dose of buprenorphine does not increase its effects. This property makes Subutex safer, as it reduces the risk of overdose compared to full opioid agonists.

How Is Subutex Administered?

Subutex is typically administered as a sublingual tablet, which is placed under the tongue to dissolve. This method ensures rapid absorption into the bloodstream and effective management of withdrawal symptoms and cravings.

Can Subutex Be Used Safely During Pregnancy?

Using Subutex during pregnancy requires careful consideration and medical supervision. According to The Recovery Village, Subutex can help manage opioid dependence in pregnant women, reducing the risks associated with illicit opioid use. However, there are potential risks to the fetus, including neonatal abstinence syndrome (NAS).

Women with a history of opioid addiction, such as Tramadol addiction, should discuss their treatment options with their healthcare provider. Comprehensive care, including individual counseling, can help manage these risks and support a healthy pregnancy.

The Grove Editorial Team is a dynamic group of professionals at The Grove, a leading addiction treatment center in Indianapolis, Indiana. Comprising experienced therapists, medical experts, and dedicated support staff, this team brings a wealth of knowledge and compassionate insight into the complexities of addiction and recovery. Their collective expertise shines through in each article, offering readers valuable guidance, the latest in addiction science, and inspiring stories of healing and transformation. The Grove Editorial Team is committed to educating, supporting, and empowering individuals and families on their journey toward a healthier, substance-free life.

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