It was once thought that buprenorphine, or Subutex, commonly used to treat addiction to heroin or other opiates, was abuse-proof. Because it is a partial opioid agonist – as compared to heroin or OxyContin, which are full opioid agonists – there is a ceiling to its effect, and it’s very difficult, if not impossible, to overdose using just buprenorphine alone.
However, in the years since buprenorphine in the form of Subutex and Suboxone was approved by the FDA for use in the treatment of opiate addiction, it has become clear that it is far from a perfect solution. Many abuse the drug, especially the Subutex form, because it does not contain the blocking agent naloxone like its sister drug, Suboxone. In fact, in Finland, Subutex is the most commonly abused opiate drug.
Many who abuse Subutex do so under the pretext of getting treatment; rather than switch to the Suboxone form of buprenorphine after the induction phase of buprenorphine detox, they instead take Subutex while also using other opiate substances. In other cases, abusers of Subutex may not be addicted to opiates and thus experience a high when they abuse this version of the drug.
Signs of Subutex Abuse
Because Subutex is an opiate, someone who is using the drug to get high – alone or in combination with other opiates – may exhibit the same signs of use that are indicative of a heroin or prescription painkiller problem. When under the influence, users may:
- Nod out or be unable to carry on a conversation or stay engaged in an activity
- Often report feeling tired or sick
- Behave as if they are confused or out of it
- Have pinpoint pupils (e.g., small pupils)
Additionally, if the person is dissolving the Subutex pill in water and injecting it rather than swallowing the pill, they will likely have needle marks at the injection sites. If their preferred ingestion method is to crush the pills before snorting them, then paraphernalia used for this purpose (e.g., razor blades, flat surfaces with white residue and scratches, rolled-up dollar bills, short pieces of plastic drinking straws, etc.) may be one of the signs of abuse.
Luckily, there is a ceiling effect for Subutex. The maximum effects are experienced at a 16 to 32 milligram dose, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Taking more of the drug rarely provides any greater or stronger effect, and overdose is rare. However, it is important to note that Subutex taken in combination with other opiate drugs like heroin, prescription painkillers, or sedatives can quickly add up to an overdose. There is no ceiling effect in these cases, and overdose remains a threat to the user. Additionally, if the person is not addicted to opiates but continues to take Subutex regularly without the need for opiate treatment, they may become dependent upon the drug.
Subutex Abuse and Addiction Treatment
Treatment for Subutex abuse is very similar to treatment for dependence upon heroin and other opiate drugs. However, because it is a partial opiate agonist, the detox portion of treatment is usually far more streamlined and comfortable. Patients often focus more on the psychotherapeutic aspect of treatment, delving into underlying mental health issues and what drove their abuse of Subutex.
Learn more about treatment options for drug abuse and dependency today. Call to talk with one of our admissions coordinators at Michael’s House now.