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How Long Do the Effects of Subutex Last? (A Timeline)

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.

Half-Life

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:

  • Dosage amount
  • Method taken
  • Frequency of dosing
  • How long Subutex has been used
  • If it's taken with other substances
  • Biological and environmental aspects

Specific Timeline of Effects

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:

WITHIN A FEW MINUTES TO AN HOUR

Subutex can impact coordination, hinder the ability to think clearly and make rational decisions and impair motor and muscle coordination. It can also induce drowsiness, fatigue, dizziness, nausea, vomiting, irregular heart rate and blood pressure, blurred vision, sweating, headache, insomnia, and potential intoxication.

UP TO THE FIRST SIX HOURS

The analgesic and painkilling effects of Subutex can last up to six hours, as can the relaxing, anxiety-reducing, and CNS-repressing impacts of the medication. Appetite can also be impacted.

WITHIN ONE TO TWO DAYS

While the analgesic and possible euphoric effects of Subutex wear off after a few hours, the drug will remain active in the bloodstream, helping to stave off likely opioid withdrawal symptoms and cravings. The respiratory and central nervous system depressant effects can continue as well. Back and joint pain, constipation, and muscle weakness may occur.

WITHIN ONE TO TWO DAYS

While the analgesic and possible euphoric effects of Subutex wear off after a few hours, the drug will remain active in the bloodstream, helping to stave off likely opioid withdrawal symptoms and cravings. The respiratory and central nervous system depressant effects can continue as well. Back and joint pain, constipation, and muscle weakness may occur.

TWO TO FOUR DAYS AFTER TAKING SUBUTEX

Over a few days, the impact of Subutex will start to wear off and lessen as the drug fully processes out of the brain and body. Withdrawal symptoms, including cravings, flu-like physical symptoms, depression, restlessness, anxiety, agitation, irritability, and mood swings, can start to become more prominent.

Influencing Factors

The duration and impact of the effects of Subutex can differ depending on many factors, including:

WHETHER OR NOT THE DRUG WAS TAKEN AS DIRECTED

This includes whether it was used for a prescribed medical need or if it was misused. Any use of Subutex without a prescription or in a way or amount other than as prescribed is drug abuse.

THE WAY SUBUTEX WAS TAKEN

Was it dissolved under the tongue as intended, or was the tablet chewed and swallowed, or crushed and snorted or injected?

HOW HIGH THE DOSE WAS

Obviously, the higher the dose, the more significant the effects and the longer the drug may stay active in the body.

BIOLOGICAL FACTORS

Personal metabolism and the presence of a co-occurring medical or mental health condition can influence the effects of Subutex and how long they last.

GENETIC IMPLICATIONS

A personal or family history of drug dependence or addiction will influence the timeline. Addiction is a heritable disease, and genetic factors may impact how quickly and significant drug dependence sets in.

LENGTH OF TIME USING SUBUTEX

The medication is habit-forming. The longer it is used, the more the body and brain will become tolerant to lower doses. Higher dosing can create drug dependence, which will then mean it will take longer for the medication to process out of the bloodstream.

OTHER DRUGS OR ALCOHOL ARE TAKEN IN COMBINATION WITH SUBUTEX

Other drugs, especially different central nervous system depressants like alcohol, benzodiazepines, or other opioids, can greatly increase the effects and impact of Subutex.

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.

Warnings

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.

Increased Side Effects With Abuse

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.