Subutex, the brand name for buprenorphine, is one of the most commonly used medications for the treatment of opioid addiction. However, Subutex is an opioid itself. As such, it replaces the previous opioid and continues the very dependence and addiction that it’s supposed to be treating. This also means that many people experience Subutex withdrawal symptoms after discontinuing its use.
If you’re trying to quit using Subutex, this can be devastating, and understandably so. Nonetheless, you shouldn’t let this demotivate you.
With professional help, you can overcome Subutex withdrawal symptoms and return to a life without opioid dependence quickly, safely, and effectively.
Key Takeaways
- Subutex is a brand name for buprenorphine, a partial opioid agonist used in medication-assisted treatment; because it is an opioid, it can cause dependence and withdrawal.
- Subutex withdrawal usually begins 24 to 48 hours after the last dose, peaks around day 3, and eases within 7 to 10 days, though psychological symptoms can last a month or longer.
- Common symptoms include fever, chills, body aches, nausea, diarrhea, insomnia, anxiety, depression, and cravings; severity depends on dose, duration of use, and how the drug is stopped.
- Subutex dependence is often managed with tapering, but Accelerated Neuro-Regulation (ANR) treats the underlying dependence in a single hospital stay without tapering or replacement medications. Speak with the ANR clinical team to learn if you’re a candidate for ANR Treatment.
What Is Subutex?
Subutex is an FDA-approved medication commonly used to treat opioid use disorder (OUD) that contains buprenorphine, a semi-synthetic partial opioid agonist derived from thebaine. It comes in the form of a sublingual tablet and is typically administered once a day.
Subutex—also known by its street name, subs—should not be confused with Suboxone. While both are buprenorphine products, Suboxone also contains naloxone.
Subutex is primarily used in medication-assisted treatment (MAT). This treatment combines medications such as buprenorphine and methadone with behavioral therapy and counseling to help people recover from opioid addiction.
When taken as intended, buprenorphine reduces opioid cravings and the risk of opioid abuse and overdose. Relieving cravings and other withdrawal symptoms can help people stay off illicit opioids.
As a partial opioid agonist, Subutex activates opioid receptors only to a certain degree and doesn’t produce the same level of euphoria as full opioid agonists like hydrocodone or oxycodone. It also has a “ceiling effect,” meaning that after a certain point, larger doses don’t amplify its effects.
While this minimizes the risk of Subutex abuse, it is still possible to misuse this drug (e.g., by crushing and snorting Subutex pills to enhance their effects), which continues the same active addiction Subutex is meant to help treat.
Subutex Usage for Treating Opioid Dependence or Severe Pain
Subutex sublingual tablet contains buprenorphine, a partial opioid agonist, and is indicated for the treatment of opioid dependence.
Subutex is a synthetic opioid drug and a partial, long-acting µ-opioid receptor agonist. This means it activates the opioid receptors slightly less than a full agonist like heroin. Subutex also has effects on the κ- and δ-opioid receptors. Due to its partial agonist pharmacological profile, the impact of Subutex plateaus at high doses.
Subutex is one of the drugs widely used for MAT of opioid use disorders such as heroin addiction. In medication-assisted opioid treatment, buprenorphine functions as a substitute for the illicit opioid on which the patient is dependent.
Over time, the goal is for the Subutex dose to be lowered over a careful tapering schedule. In this capacity, buprenorphine has been included in the WHO list of essential medications. Buprenorphine is also a potent analgesic used for the short and long-term treatment of severe pain not adequately controlled by non-opioid drugs.
Subutex Withdrawal Symptoms
Subutex withdrawal symptoms are the physical and psychological effects that appear when someone dependent on buprenorphine reduces or stops the drug. Because Subutex is a long-acting opioid, symptoms often begin 24 to 48 hours after the last dose and can last up to a month.
You may experience Subutex withdrawal symptoms, which can be both physical and psychological.
Like any other opioid, buprenorphine taken for pain control can eventually lead to tolerance, dependence, and addiction. In the case of the patient using Subutex for opioid use disorder, the original dependence is simply continued on a prescription opioid medication. Opioids exert their analgesic and euphoric effects by binding to and activating the opioid receptors in the central nervous system, which releases endorphins. Endorphins are the body’s natural method of pain relief. They can also promote feelings of well-being and euphoria.
With long-term Subutex use, the endorphin and opioid receptor system changes and adapts to a new functional level. Opioid receptors begin to respond to activation, leading to the development of opioid tolerance.
In an attempt to get the same feeling as before, many patients begin to increase their Subutex dosage, leading to a dangerous spiral of opioid dependence and addiction. If you suddenly stop taking Subutex after becoming dependent on it, you’ll inevitably experience withdrawal symptoms.
Subutex withdrawal symptoms often look similar to those of other opioids and may include:
- Anxiety
- Bone, muscle, and joint pain
- Chills
- Depression
- Diarrhea
- Excessive yawning
- Fever
- Headaches
- Insomnia
- Mood changes
- Nausea and vomiting
- Opioid cravings
- Pupil dilation
- Sweating
- Watery eyes and runny nose
Buprenorphine can also cause precipitated withdrawal symptoms. These occur when Subutex is taken prematurely while another opioid is still in the system. This can be prevented by waiting for the onset of opioid withdrawal symptoms before administering Subutex.
Subutex Withdrawal Timeline
The Subutex withdrawal timeline typically runs about a month. Physical symptoms start within 24 to 48 hours, peak around day 3, and subside within 7 to 10 days, while psychological symptoms can persist for several weeks.
How long Subutex withdrawal lasts depends on several individual factors—the Subutex dose taken, the duration of buprenorphine use, the patient’s health condition, etc. Whether or not you’re undergoing any Subutex detox treatment can also impact how long your symptoms last.
Let’s break down the typical Subutex withdrawal timeline by days:
Days 1–2
Onset, usually 24 to 48 hours after the last dose.
- Irritability and restlessness
- Diarrhea
- Flu-like symptoms such as runny nose and headache
Days 3–10
Physical symptoms peak, then begin to subside.
- Fever and insomnia
- Mood swings
- Nausea and vomiting
- Body aches
Days 11–30
Psychological symptoms may intensify.
- Depression
- Intense cravings
- Anxiety
- Symptoms can last up to a month and raise the risk of relapse and buprenorphine overdose.
Subutex Post-Acute Withdrawal Syndrome (PAWS)
Subutex PAWS is a set of psychological symptoms, such as cravings, low mood, and poor concentration, that can persist for months after the acute withdrawal phase ends.
For some people, buprenorphine withdrawal symptoms gradually fade away within a month or two. For many, however, these symptoms may last several more months, or even years, exposing them to a high risk of relapse and affecting the overall quality of their lives.
Subutex PAWS is mainly associated with psychological withdrawal symptoms, such as:
- Intense opioid cravings
- Depression
- Anxiety
- Difficulty concentrating
- Apathy
- Mood swings
Although PAWS can cause you to lose hope in recovery, don’t let it discourage you. With medical help, you can overcome any ongoing Subutex withdrawal symptoms you’re suffering from and return to a normal, healthy daily life.
How to Manage Subutex Withdrawal Symptoms
To manage Subutex withdrawal symptoms safely and effectively, seek help from medical professionals. Your doctor can explain how to get off Subutex safely. To prevent uncomfortable withdrawal symptoms, they’ll likely suggest following a tapering schedule.
Under no circumstances should you quit Subutex abruptly, as this can trigger more intense Subutex withdrawal symptoms. Tapering off opioids, including buprenorphine, in theory gives your body more time to slowly adjust to lower doses of the drug.
Withdrawal from Subutex can be very unpleasant and painful. To minimize the risk of relapse and a potentially fatal opioid overdose, you should never attempt to get off Subutex without medical supervision.
Be wary of Subutex detox centers that claim they can get you off buprenorphine in a couple of days. Subutex detox simply helps remove the medication from your system, but it does not repair the damage opioids cause to the endorphin-receptor system.
Since it only treats the symptoms but not the cause of addiction, Subutex detox often leads to relapse. Due to lowered opioid tolerance, you may be at a greater risk of overdose, coma, brain damage, and death after detoxing from Subutex.
Risks and Dangers of Taking Subutex
As is the case with any opioid, taking Subutex puts you at risk of opioid abuse and overdose.
Initially, Subutex (and its ingredient, buprenorphine) was marketed as a drug with a very low potential for abuse. With time, however, it became clear that it had its own potential for misuse. It is most frequently abused by injecting it intravenously or by crushing pills and then snorting Subutex powder.
A 2010 study found that slightly above 35% of patients receiving buprenorphine for opioid addiction treatment misused this medication by injecting it, with half of the patients doing this in an attempt to relieve opioid withdrawal symptoms. Less than 13% of these patients misused it to get “high.”
That aside, Subutex can cause various side effects, ranging from mild to potentially life-threatening. These include:
- Constipation
- Nausea
- Vomiting
- Dizziness
- Drowsiness
- Confusion
- Dry mouth
- Headache
- Respiratory depression
If you experience severe nausea and vomiting, whether as a Subutex withdrawal symptom or a side effect of the medication, seek medical help. If left untreated, this could lead to extreme dehydration and electrolyte loss, which can be fatal.
Subutex Rapid Detox
Subutex rapid detox is an anesthesia-assisted opioid detox method that can quickly flush buprenorphine out of your system, most often with the help of naloxone or another opioid antagonist. When performed under anesthesia, rapid detox diminishes the intensity of painful and uncomfortable withdrawal symptoms, but it doesn’t completely eliminate them.
The cost of Subutex rapid detox can go up to $24,000, but despite its hefty price, this treatment doesn’t ensure long-term recovery from opioids. In fact, it isn’t unheard of for patients to relapse soon after undergoing rapid Subutex detox, which can be life-threatening since the procedure decreases their opioid tolerance.
Not only is rapid detox from Subutex ineffective in treating opioid addiction, but it is also not safe. This procedure can lead to various complications and adverse events, including pulmonary edema, heart attack, and suicidal ideation.
ANR Opioid Treatment for Subutex Addiction
Accelerated Neuro-Regulation (ANR) treats the physical dependence behind Subutex addiction so that recovery does not depend on ongoing medication or tapering.
The ANR treatment goes beyond detox and withdrawal symptom management that most other opioid dependency treatments, including rapid detox, aim to achieve.
Unlike Subutex rapid detox, ANR negates the risk of ongoing withdrawal symptoms and relapse by re-regulating the endorphin-opioid receptor system and addressing the root cause of opioid dependence. By modulating the endorphin-opioid receptor system under sedation, ANR allows patients to leave treatment without the physical dependence that brought them in.
ANR doesn’t replace Subutex with other potentially addictive medications. Unlike other treatments, it enables you to resume your regular life and leave opioids in the past right after a short hospital stay.
If you or someone you care about is weighing Subutex detox options, speak with a member of the ANR team to learn if you’re a candidate for ANR Treatment.
“Maintenance swaps one opioid for another, indefinitely. Our goal is the opposite — to repair the system so the medication is no longer needed.”
Dr Andre Waismann, Developer of ANR
Subutex Withdrawal & Detox FAQ
1. How long does Subutex withdrawal last?
Subutex withdrawal typically lasts up to a month. Physical withdrawal symptoms usually subside within the first 10 days after quitting Subutex, but psychological symptoms may linger for several weeks. That said, how long Subutex withdrawal lasts depends on various individual factors ranging from the extent of your opioid use to your metabolism.
2. How long does it take to detox from Subutex?
How long it takes to detox from Subutex largely depends on the Subutex detox treatment you use, if any. Without any treatment, Subutex detox often lasts around a month. With the ANR treatment, you can bypass the withdrawal process altogether and make a long-lasting recovery from Subutex addiction within days.
3. What are the signs of Subutex use disorder?
Tell-tale signs of Subutex use disorder include abusing the medication (e.g., snorting Subutex or taking it without a prescription) and experiencing intense cravings or other withdrawal symptoms after discontinuing its use. People with a Subutex use disorder will also typically spend a lot of time obtaining, using, and recovering from buprenorphine.
4. Can Subutex cause opioid addiction?
Subutex is an opioid medication, and it can cause addiction when used to manage pain. In the case of medication-assisted treatment (MAT) for opioid use disorder, patients are prescribed Subutex because they are already dependent on opioids, so Subutex continues the existing dependence rather than creating a new one.
5. What eases Subutex withdrawal?
Medically supervised care is the safest way to ease Subutex withdrawal. Doctors may use a gradual taper and supportive medication for symptoms, but these manage discomfort rather than resolve the underlying dependence. ANR Treatment addresses the dependence directly at its root and without replacement medication.
6. Can Subutex cause precipitated withdrawal?
Yes. Because Subutex is buprenorphine, taking it while a full opioid is still in the system can trigger precipitated withdrawal, a sudden and intense onset of symptoms. To avoid it, Subutex should only be started once mild-to-moderate opioid withdrawal has already begun.
7. How is Subutex different from Suboxone?
Subutex contains only buprenorphine, while Suboxone combines buprenorphine with naloxone. The naloxone deters misuse by triggering withdrawal if the drug is injected. Both treat opioid dependence, and their withdrawal timelines and symptoms are broadly similar.
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