Injecting Subutex is never safe. This is an abuse of the drug, and it carries the potential for a fatal overdose.
Subutex is an opioid drug containing the partial agonist buprenorphine. It is prescribed in 2 mg or 8 mg sublingual tablets that are placed under the tongue and dissolved.
Crushing and injecting Subutex sends the medication into the bloodstream faster for a quicker and more intense high. The journal Current Drug Abuse Review publishes that injecting buprenorphine is technically the most effective way to use the drug.
When doing so, much lower doses are necessary for it to work. This also means that injection of Subutex is much riskier than other methods of ingestion, as it will work much faster and have a greater impact in significantly smaller doses.
Subutex should always be taken exactly as directed to minimize the possible side effects and risk for fatal overdose, drug dependence, and addiction.
The U.S. Food and Drug Administration (FDA) approves buprenorphine and Subutex as medications for treating opioid dependence. Buprenorphine is a long-acting partial opioid agonist that can help to manage cravings and opioid withdrawal symptoms during an addiction treatment program.
The fact that buprenorphine is only a partial opioid agonist means that it does not have quite the same analgesic or euphoric effects as other full agonist opioids like heroin or other prescription opioids.
The Substance Abuse and Mental Health Services Administration (SAMSHA) publishes that buprenorphine also has a limit to its agonist effects. After a certain amount is taken, the high levels off.
Injecting Subutex changes the way the drug is metabolized in the body and sends it across the blood-brain barrier much faster. Immediate impacts of shooting Subutex can include the following:
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A Subutex high can look similar to alcohol intoxication, and similar risk factors are possible.
Buprenorphine is an opioid drug, which means that it is a central nervous system depressant that slows down respiration, heart rate, and blood pressure.
It also has a mind-altering impact, as the activation of opioid receptors in the brain induces a higher level of the naturally occurring chemical messenger dopamine to be present. Dopamine is involved in eliciting pleasure and regulating emotions, but it is also involved in learning, memory, sleep, and movement functions as well.
Injecting Subutex increases all of the potential side effects of the drug.
The prescribing information on Subutex warns that intravenous (IV) use of the buprenorphine, especially when combined with other depressant substances like alcohol, other opioids, or benzodiazepine drugs, can cause significant respiratory distress and death. Most of the reported deaths are from self-administration and injection of the drug.
Subutex is not meant to be taken this way, and injecting it can be fatal.
Subutex is also a long-acting opioid, but the euphoric and analgesic impact doesn’t last as long as the duration of action of the medication in the body. This can make it seem like the drug is no longer present and encourage a person to take more, leading to a toxic buildup and overdose.
In addition to shallow breathing and the potential for someone to stop breathing, the following are signs of a Subutex overdose:
The U.S. Centers for Disease Control and Prevention (CDC) publishes that close to 50,000 Americans lost their lives to an opioid overdose in 2017. More than a third of these deaths involved a prescription opioid.
The U.S. Drug Enforcement Administration (DEA) reports that buprenorphine is increasing as a drug of abuse and often used as a substitute for heroin.
An overdose involving an opioid-like Subutex requires immediate medical intervention and often the administration of the opioid antagonist drug naloxone (Narcan).
Illicit Subutex may not even be what it is purported to be. Many illegal drug distributors are creating counterfeit prescription tablets that look like the originals but may be cut or laced with far more potent opioids.
Counterfeit pills may contain the synthetic drug fentanyl or U-47700, both of which can be lethal in much smaller amounts than Subutex. The fake pills may contain be comprised of drugs or substances. It can be next to impossible to know how they will react in your body and at what level.
The Washington Post warns that drug distributors are using pill presses, and their products often look just like the originals. There may be no way to tell by looking at them that these products are fake.
Fake prescription pills are appearing more and more on the market, and they are linked to many deaths as a result. These products are extremely dangerous.
Injecting a possible counterfeit product can significantly amplify the hazards for a life-threatening overdose that may be even more difficult to try and reverse. It may take multiple doses of Narcan to overturn it.
Injecting Subutex raises the level of drug tolerance more quickly. It will take higher doses each time to feel the same way.
Drug dependence can set in more rapidly when Subutex is injected regularly. When a person struggles with drug dependence, withdrawal symptoms may occur after Subutex wears off. These may include intense mood swings and emotional lows, cognitive difficulties, and physically significant flu-like symptoms.
The severity of opioid withdrawal symptoms and cravings can encourage a person to keep taking opioids like Subutex. The lack of ability to control Subutex use or be able to stop taking it can indicate addiction, which is a chronic disease.
As published by the American Society of Addiction Medicine (ASAM), over 2 million people in the United States struggled with addiction involving a prescription opioid drug in 2016. Injecting Subutex raises the level of drug tolerance and dependence more rapidly and elevates the potential for addiction.
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(May 2016). Buprenorphine. Substance Abuse and Mental Health Services Administration. Retrieved March 2019 from from https://www.samhsa.gov/medication-assisted-treatment/treatment/buprenorphine
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(November 2017). Counterfeit Opioid Pills are Tricking Users- Sometimes with Lethal Results. Washington Post. Retrieved March 2019 from from https://www.washingtonpost.com/national/counterfeit-opioid-pills-are-tricking-users–sometimes-with-lethal-results/2017/11/19/d34edb14-be4b-11e7-8444-a0d4f04b89eb_story.html?utm_term=.14cddcb06d93
Opioid Addiction 2016 Facts & Figures. American Society of Addiction Medicine. Retrieved March 2019 from from https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf