Subutex is a brand name for a drug that contains buprenorphine, a partial opioid agonist used for the treatment of opioid dependence. Though the Subutex trade name product has been discontinued, it was not done so for issues of safety or effectiveness; similar pharmaceutical products remain available today. By acting as a partial agonist on opioid receptors throughout the body, the buprenorphine in Subutex helps to prevent or minimize withdrawal symptoms in people recovering from opioid use disorders. When taken as recommended, buprenorphine can be a safe and effective addiction treatment medication. Buprenorphine is used as part of the medication-assisted treatment (MAT) approach, which combines medications and behavioral therapy to treat substance use disorders (SUDs).
What Makes Subutex Different?
The main difference is that Suboxone contains both buprenorphine and naloxone, whereas Subutex contains only buprenorphine. Suboxone and Subutex are both brand names. While both drugs were developed at around the same time, Subutex was formulated first and while it was found to be relatively effective in the treatment of opiate addiction, there was still a tendency to abuse the drug. Many users sought to inject the drug intravenously in order to obtain the high they had become accustomed to with heroin or prescription painkillers. They often succeeded in doing so, giving rise to the need to develop another drug to address this issue: Suboxone.
In Suboxone, naloxone was combined with buprenorphine to deter abuse of the medication. Naloxone is an opioid antagonist, which means that it blocks the effects of opioids at the receptor sites. If someone injects Suboxone, the person will immediately go into precipitated withdrawal, which can be distressing.
Just as with any medication used in MAT, buprenorphine is one part of a comprehensive treatment plan that also includes counseling and behavioral therapies–to better provide a “whole-patient” approach to addiction treatment.
Treatment with Buprenorphine
In the 12-month period ending April 2021, more than 75,000 Americans died from an opioid overdose. In the same year, 1.7 million people in the U.S. were estimated to struggle with an opioid use disorder involving prescription painkillers.7 Prescription opioid diversion and misuse puts the lives of millions of people at risk; however, medications like buprenorphine are available to help people like these treat their opioid use disorders.
According to the World Health Organization, buprenorphine is essential medicine. While some may have concerns that MAT with opioid agonists such as buprenorphine merely replaces one drug with another–or one addiction for another–that is not the case. Once adjustments are made, stabilizing doses of buprenorphine should not get the user high. Instead, MAT programs provide closely monitored and carefully dosed amounts of the treatment drug to prevent withdrawal, decrease cravings, and ultimately disrupt the compulsive cycle of drug use that would otherwise continue to drive an untreated opioid use disorder. Additionally, buprenorphine prescribed at the appropriate dose should have no unfavorable effects on a patient’s mental capability, physical capability, or job success.
Will I Go Through Withdrawal if I Stop Taking Subutex
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.
Subutex Side Effects
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.
Can I take Subutex While Pregnant?
Pregnant women with opioid addictions receive MAT during their pregnancy in order to reduce risks of opioid abuse and withdrawal as well as promote 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 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.
