Subutex (buprenorphine) is one of three medications that are approved by the U.S. Food and Drug Administration (FDA) to treat opioid dependence. It is a sublingual tablet that is meant to be dissolved under the tongue and absorbed into the body through the membranes of the mouth.
Pharmacy Times reports that buprenorphine has a half-life of 24 to 42 hours. The half-life of a drug is how long it takes it to be half as active in the bloodstream. Buprenorphine can remain at least partially active in the body for two to almost four days.
Some of the effects of buprenorphine may wear off faster than that, however. When misused, the buprenorphine high will last a few hours at most. The pain-relieving, or analgesic, effects of buprenorphine also do not last as long.
Various factors are all involved in how quickly Subutex processes out of the body and how long the effects of the drug may last. These include:
The active chemical in Subutex, buprenorphine, is a partial opioid agonist medication. It acts on opioid receptors in the brain to impact pain sensations, and it also works as a central nervous system depressant.
As a partial agonist, buprenorphine does not engage the opioid receptors as fully or have as drastic an impact on brain chemistry as full agonists, such as prescription narcotic painkillers or heroin. The impact of Subutex can be a little more muted than other opioids, but most full agonist opioids are also relatively short-acting. Their effects wear off much more quickly than Subutex.
Subutex can stay active in the system for up to four days, making it an optimal candidate for managing opioid dependence and withdrawal symptoms. Subutex is often substituted for other opioids during a complete addiction treatment program. This can combat cravings and keep difficult withdrawal symptoms from being as significant. In general, the effects of Subutex will adhere to the following timeline:
The duration and impact of the effects of Subutex can differ depending on many factors, including:
If Subutex is taken too soon after another opioid drug is taken and before it fully processes out of the body (usually within six hours or so), it can precipitate acute opioid withdrawal. Nausea, vomiting, diarrhea, chills, sweating, irregular heart rate, runny nose, watery eyes, muscle aches, insomnia, depression, anxiety, and trouble thinking clearly can occur.
When used to manage opioid dependence, Subutex should only be taken after withdrawal begins, and the other opioids have fully processed out of the bloodstream.
Subutex is meant to be taken in as low a dose as possible, coming in 2 mg and 8 mg tablets that are to be placed under the tongue and dissolved.
The prescribing information for Subutex warns that the drug is intended to treat opioid dependence and not designed to be used as a pain-relieving medication. Even though it has analgesic effects, it can also cause potentially fatal respiratory distress.
The U.S. Drug Enforcement Administration (DEA) warns that buprenorphine abuse is increasing, both with other substances but also as a primary drug of abuse and as a substitute for heroin.
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When taken in a way other than it was intended to be taken, Subutex can cause a pleasant and euphoric high. It can also increase the odds for a life-threatening overdose and bring a greater risk for drug dependence and addiction.
Altering Subutex and the intended method of ingestion changes the bioavailability of the drug. This can make it more potent, have a greater impact, and carry more significant effects and a longer duration of action.
According to the National Survey on Drug Use and Health (NSDUH), more than 700,000 American adults misused a buprenorphine medication in the month prior to the 2016 survey.
Misuse of Subutex can increase the potential side effects and risk factors. It can also impact the timeline of how long and how intensely the medication will be active in the brain and body.
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(March 2016). A Brief Review of Buprenorphine Products. Pharmacy Times. Retrieved March 2019 from from https://www.pharmacytimes.com/contributor/jeffrey-fudin/2016/03/a-brief-review-of-buprenorphine-products
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(July 2013). Buprenorphine. U.S. Drug Enforcement Administration. Retrieved March 2019 from from https://www.deadiversion.usdoj.gov/drug_chem_info/buprenorphine.pdf
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved March 2019 from from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm