In this article, I’m going to teach you everything you need to know about the use of Subutex for opiate withdrawal. Over the past several years, many people have asked me the question:
“Does Subutex work for opiate withdrawal?”
The answer is “yes” – but only if the Subutex is used correctly.
If you use Subutex too soon after taking your last opiate, you will experience a phenomenon called “precipitated withdrawal,” which is a HORRIFIC experience.
I’ll discuss precipitated withdrawal and how to avoid it in detail later. But before I cover this, I’m going to explain how Subutex is able to help you get rid of opiate withdrawal symptoms.
Once I’ve taught you the basics, then we’ll move right along to the section on how to use Subutex for opiate withdrawal in a way that is safe and effective.
Why Does Subutex Work For Opiate Withdrawal?
So we already know that Subutex helps with opiate withdrawal. So the question then becomes: “how does Subutex help with opiate withdrawal?” It’s actually a pretty simple process and one that I find fascinating.
Here are the basics on Subutex:
Subutex is a brand name formulation of a drug called buprenorphine. Buprenorphine is a controlled substance and semisynthetic opioid derivative of thebaine.
Buprenorphine attaches and binds to the same opioid receptors in the brain and other parts of the body that drugs like heroin, oxycodone, hydrocodone, and other opioids bind to. Once it attaches to these receptors, it mimics the effects that opioid drugs produce (though it’s not as powerful).
For this reason, buprenorphine is known as a “partial opioid agonist.”
The other opiate drugs I just mentioned are known as “full opioid agonists,” because they activate the receptors in a stronger and more complete way than buprenorphine. See the illustration below.
Opiate Withdrawal 101
To further illustrate why Subutex works so well for opiate withdrawal, I’d like to give you the basics of the opioid withdrawal syndrome. If an individual continues using opioids after a tolerance has been established, they will eventually develop a physiological dependence.
Dependence develops when the neurons adapt to the repeated drug exposure and only function normally in the presence of the drug.
When a dependent individual abruptly stops taking opioids (leading opioid-blood concentration to fall below the required level), the now opioid-tolerant central nervous system (CNS) goes haywire.
With no inhibitive stimulation to satisfy receptors, the pathways of the CNS fire signals strenuously, performing at a level much higher than pre-dependence levels.
Now the locus coeruleus responds by triggering the autonomic fight or flight response.
What results is known as the opioid withdrawal syndrome, and it’s one of the most agonizing experiences an individual could ever go through.
Some of the most common symptoms of opioid withdrawal include:
- Anhedonia (inability to feel pleasure)
- Achy muscles and limbs
- Teary eyes
- A runny nose
- Gastrointestinal distress
- Hot and cold sweats and chills
- Restless Leg Syndrome (RLS)
Using Subutex For Opiate Withdrawal
A quick fix for stopping this syndrome is to use Subutex for opiate withdrawal. After an individual takes a dose of Subutex, the buprenorphine quickly binds to the opioid receptors, and if enough is taken, withdrawal symptoms and opiate cravings are eliminated or drastically reduced.
This is something I am familiar with on a very personal level.
Years ago I was a cook at a fast-paced restaurant in New York. I was addicted to OxyContin and Percocet, and I needed to purchase them illegally and take them daily to avoid getting sick and missing work.
I also had a newborn baby to take care of after work, so between those two main responsibilities, going through acute withdrawal and then being exhausted and depressed for weeks to months was simply not an option. I needed to work to pay bills, but more importantly, my addiction was a secret, so I continued to use to avoid getting sick and bringing attention to myself.
Several months into my addiction, my life was getting more and more out of control.
Then something truly saved me.
One day I woke up without opiates and was in the first stages of withdrawal. I started texting every dealer I knew to see if anyone could deliver prescription opiates to my work, as I had to be there at 8 am, and without the pills, it would be very difficult to function.
At 9 am, one of my dealers met me out back by the dumpster and pulled out an orange tablet of Suboxone (another buprenorphine product). He sold it to me for $20. I went to the bathroom at work and administered a fourth of the pill, which contained approximately 2 mg of buprenorphine.
Within minutes I was feeling better!
No more opiate withdrawal, no more cravings, I had energy, I was happy, work was fun, and I quickly decided that taking buprenorphine was much better for me than snorting OxyContin.
It seemed like a miracle medication until my dealer ran out of it a few months later.
By my third day without buprenorphine, I was so tired and depressed that I just said “screw it” and bought some oxy’s, and the vicious cycle continued.
How To Use Subutex For Opiate Withdrawal
Alright, so now you know why so many people use Subutex for opiate withdrawal…because it works! And now we’ve reached the “How-To” portion of this article.
To use Subutex for opiate withdrawal in a manner that is safe and effective, there are certain guidelines to follow.
The first guideline is to use the appropriate “timing.”
Subutex should not be taken too soon because precipitated withdrawal can start if you take Subutex before the other opioid drug completely leaves your body. The timeline may differ from person to person depending on several factors, including personal physiology and genetics.
Generally speaking, you should wait to take Subutex the following amounts of time after your last dose of these specific drugs:
Note: A general rule of thumb is to wait until you’re experiencing moderate opioid withdrawal symptoms. Prior to induction, doctors typically look for their patients to have objective withdrawal symptoms sufficient to produce a score of a 5 to 6 on the Clinical Opiate Withdrawal Scale (COWS).
What Is Precipitated Withdrawal?
Subutex-precipitated withdrawal can occur when an individual takes Subutex too soon after taking a full opioid agonist (such as heroin, oxycodone, hydrocodone, etc). Due to buprenorphine’s high affinity but low intrinsic value at the mu opioid receptor, buprenorphine displaces full agonists from these receptors without activating the receptor to an equivalent degree.
This leads to a net decrease in opioid agonist effect, thus precipitating a withdrawal syndrome.
How Much Subutex Should I Take For Opiate Withdrawal?
The second guideline to follow when using Subutex for opiate withdrawal has to do with “quantity.”
Even if you have the timing right, that doesn’t necessarily mean you’ll be free of opiate withdrawal symptoms. To effectively reduce symptoms, you’ll want to use the appropriate dosage.
So how much Subutex does it take to eliminate opiate withdrawal symptoms?
That depends on several things, the most important being:
- How long you’ve been using opiates
- What types of opiate or opiates you’ve been using
- The average amount of opiates you’ve been using on a daily basis
On Day 1 of opiate withdrawal, clinicians should start with an initial dose of 2 mg or 4 mg buprenorphine and may titrate upwards in 2 or 4 mg increments of buprenorphine, at approximately 2-hour intervals, under supervision, to 8 mg based on the control of acute withdrawal symptoms. So the maximum buprenorphine that should be taken on Day 1 is 8 mg, and for Day 2, the maximum amount is increased to 16 mg.
How Do I Administer Subutex?
Subutex comes in a tablet form and it’s used as a sublingual medication that dissolves in your mouth. You do not swallow the medication.
The following guidelines should be adhered to when taking Subutex tablets:
- Before taking Subutex, drink water to moisten your mouth. This helps the tablet dissolve more easily.
- Place Subutex under your tongue, close to the base either to the left or right of the center.
- If your doctor tells you to take 2 tablets at a time, place the second tablet under your tongue on the opposite side. Try to avoid having them touch as much as possible.
- Keep the tablets in place until they have completely dissolved.
- While Subutex is dissolving, do not chew or swallow the tablet because the medicine will not work as well.
- Talking while the tablet is dissolving can affect how well the medicine in Subutex is absorbed.
Subutex For Opiate Withdrawal Conclusion
Many people have used Subutex for opiate withdrawal symptoms. If used correctly, Subutex can eliminate withdrawal symptoms and cravings very well. However, if used incorrectly (taking it too soon), the buprenorphine in Subutex can precipitate withdrawal.
This is a very unpleasant experience.
I’ve never gone through precipitated withdrawal, but I’ve talked to many people that have. It’s a terribly awful experience and one that can be avoided with the proper knowledge.
Some individuals choose to use Subutex for opiate withdrawal symptoms for a few days just to get them through the acute withdrawal period. Others find that a few weeks to a few months of Subutex treatment will increase their chances of success.
Finally, there are individuals that choose to be in Subutex maintenance treatment for several months or years.
Everyone is different, so different approaches will work for different people. Subutex may be a good choice for some people, and for others, medication may not be the way to go.
I believe that there are many paths to recovery. Find your path, and don’t let anyone tell you that your path is wrong.
They only do this because it doesn’t obey their rules for recovery.
Follow your heart, and you’ll be guided to the right path. Click here now to view my best home detox program.
If you have any question on using Subutex for opiate withdrawal, please post them in the comment box below.
Matt, I think that what you are doing is extremely admirable ! You only keep what you have by giving it away. I am about to start using Sabbies again through a proper drug agency. I have had years of clean time, only to relapse again. At the age of fifty, one is finding it difficult to motivate one’s self. Keep up da good work.
Terran Ulysses B.
I take 3 Percocet 10 mg a day for about 21/2 years now. I don’t abuse them but the last two months I Was hurting more and took a few extra. I’m am now forced to reduce to 1/2 of normal dosage and will still be a day or two short of my refill. I have one 8 mg Subutex and wondering if taking 2 mg after I run out, for a day or two will help with withdrawal. I can feel a difference already with only taking 1/2 my normal dosage and I have a week to go on the 1/2 dosage and I will probably have a day or two without any until my Rx will be filled. Thanks for any advice. Also wondering how long to wait after taking 5 mg x two the last day before I try the 2 mg of Subutex.
I was prescribed Lortab for several years long story short my dr. retired and told me to find another doctor before I went through with drawl. That led to me getting it from some the Street. Using them for about 10 years led to her use of heroin for about a year and a half. I took Subutex for about 12 days at very small doses, I tapered down but only to about 1 or .5 mgs and then stopped taking it. After about 5 days I got really bad back pain and leg pain and was very irritable and had some stomach issues. After the 7th day with nothing I got 2 more 8 mg tablets of sub and just went a day without taking it. I got 2 more yesterday and took 4mgs I’m hoping to skip a day of taking it and use the rest at VERY small doses. In your opinion do u think I will still face the same problem days after I stop using it? I don’t want to be on it for a long time. Also I have used H or any other opiates in about a month.
I told my paid Dr. I wanted to get off pain meds. I’ve been on them for years with a spinal injury. After I told him that he gave me my regular prescription 5, 15mg a day and a rx for subutex. He told me to take my regular meds as usual and add in Subutex in the morning. I saw this posted online and even called him back to verify I’m supposed to be taking both oxycodone and Subtux, he confirmed yes. So, what’s up with that! I’m not trying to go into a precipitated withdrawal. Also, the pharmacist had said to just start on the subs no more oxy. Totally confused now.
I don’t think that they should both be taken concurrently. When I went to the clinic they wanted to CERTAIN about the timing of my last dose of any opiates.
It Jas been a awhile. I’m doing good and still on suboxone maintenance. Question is can some people be on suboxone for life or do the Drs, Government, DEA want people to get of the suboxone program ASAP? Even though it is classfied as Schedule 4, is it ok for some to be on it for life? I know your goal is for people to be free from any drugs including Sub. There are many who can’t get off and prefer to maintain on Sub for life.
Hi Tim that’s not my goal. My goal is to help people find and use the treatment method that resonates with them the most. That’s why my site is so diverse. I am a full supporter of medications but if people want off them, there are methods to do that. 🙂