Subutex Assisted Heroin/Opioid Detox
Commonly known as buprenorphine, Subutex is an opioid-based substance used to treat moderate to severe pain. As well as being an effective painkiller, this medication is often prescribed as a substitute for heroin or other addictive opioids as part of a detoxification programme.
Subutex has been found to reduce and alleviate many of the more uncomfortable opioid withdrawal symptoms as well as being effective at decreasing cravings for these substances. If a person attempts to ingest heroin or other addictive opioids while on a Subutex treatment programme, the euphoric and pleasurable effects that they would usually experience will be blocked making these substances less physically and psychologically appealing.
While Subutex is potentially addictive and comes with a mild risk of overdose particularly when combined with other substances, it has fewer withdrawal symptoms and provides less euphoric and pleasurable effects than most other opioid-based medications. [1]
How is Subutex used in heroin or opioid detox?
Subutex can be prescribed as an alternative to heroin or other opioid-based substances. The patient will receive a regular dosage of this medication which is manufactured in a professional, sterile environment and measured according to their height, weight and personal requirements. As their cravings will be fulfilled by Subutex, the patient will no longer feel compelled to ingest more dangerous substances such as heroin.
Commonly prescribed as a tablet that is placed underneath the tongue and dissolves within 5-10 minutes, Subutex can also be taken in wafer or tablet form both of which melt in the mouth. It is not necessary to smoke, snort or inject this substance, making it much safer than the majority of street drugs.
At the beginning of the treatment programme, patients will usually be required to ingest Subutex under the supervision of the pharmacist. As the programme progresses, they may be permitted to take the medication in the privacy of their own home.
It is common for patients to continue the treatment programme for long periods of time due to concerns over relapsing back into heroin addiction, and as a result, Subutex can be prescribed on a short or long-term basis.
What are the benefits of using Subutex in heroin or opioid detox?
Subutex has been proven to be effective when used as part of a professional detoxification programme and comes with a range of benefits that go further than simply preventing drug use. [2]
Common benefits of Subutex in heroin or opioid detox include:
1. Reduces the rates of risky needle-sharing and injecting
Heroin and other opioids are often injected directly into the bloodstream and many people abusing these substances will share needles with each other, increasing the risk of contracting blood-borne infections such as HIV and hepatitis.
As Subutex is ingested in tablet or wafer form, the risk of contracting an infection is drastically reduced, and the manufacturers of this medication are held to strict hygiene and medical standards.
2. Makes addictive substances less appealing
As mentioned above, Subutex has the ability to make addictive substances seem less appealing by blocking the euphoric and pleasurable effects that many people experience when ingesting heroin.
When Subutex is combined with another medication known as Suboxone, it can induce withdrawal symptoms if the patient attempts to snort the substance or take more than the prescribed dosage.
3. Reduces criminal activity
Many people dealing with an opioid addiction may resort to criminal activity in order to fund their dependence including stealing, purchasing from dealers, using violence and engaging in illegal street prostitution.
A regular prescription for Subutex can reduce these behaviours as the medication is dispensed safely and legally, removing the need to commit offences in order to obtain the substance.
4. Less chance of overdose
The body can quickly build up a tolerance to heroin, requiring a higher dosage in order to experience the same effects. This tolerance can be reduced just as quickly once the individual stops taking heroin for a short period of time, increasing the chances of an overdose in the event of a relapse if they attempt to ingest their usual dosage.
Subutex reduces the risk of relapse by alleviating many of the most uncomfortable withdrawal symptoms and removing the craving for heroin, potentially preventing many accidental overdoses.
5. Helps patients to complete treatment programme
Recovering from a heroin or other opioid addiction can be notoriously difficult, as the withdrawal symptoms can be extremely unpleasant and hard to deal with. As a result many people are unable to complete a treatment programme without medical assistance and may relapse after experiencing withdrawal symptoms, and may therefore be less likely to attempt recovery again in the future.
As Subutex acts as a replacement for the addictive substance, the patient will avoid many of the most uncomfortable withdrawal symptoms as well as the cravings that usually manifest as part of the detoxification process, helping them to progress through the treatment plan and increasing the rate of successful completion.
What are the side effects of Subutex?
While the use of Subutex can be extremely beneficial in patients who are attempting to detox from a heroin or other opioid addiction, the use of this medication can result in a number of physical side effects.
In general, the positive effects will far outweigh the negatives, but in some cases, it may be advantageous to switch to an alternative medication if the patient is experiencing discomfort on Subutex.
Common side effects of buprenorphine include:
- Nausea and vomiting
- Digestive problems including constipation
- Tooth decay
- Severe headaches
- Increased weight gain
- Decreased sex drive
- Excessive perspiration
- Drowsiness and fatigue
- Loss of appetite
- Skin irritation including hives and rashes
- Changes to the menstrual cycle
Rare side effects of buprenorphine include:
- Irregular heartbeat
- Frequent chills
- Difficulty swallowing
- Blurred vision
- Depression
- Extreme tiredness and exhaustion
- Skin that is swollen, bleeding or hot to the touch
If you are concerned about any of the side effects you experience while taking Subutex, speak to your doctor immediately who will be able to adjust the dosage or prescribe an alternative medication.
Subutex use – what are the laws?
Subutex is classified as a Class C controlled substance in the UK, making it illegal to possess this medication without a current prescription. [3]
If you are found guilty of the possession of Subutex you can be sentenced to up to two years in prison, potentially including an unlimited fine. The sentences around the illegal supply and manufacturing of this substance are even more severe, with the possibility of up to 14 years in prison and/or an unlimited fine. These penalties can depend on a number of factors including the amount of Subutex found, whether it is intended for personal use and your personal criminal history.
Many people see Subutex as a fairly safe substance to ingest recreationally as it can be obtained with a medical prescription, but these laws are in place precisely because this medication is addictive and potentially dangerous.
Can I overdose on Subutex?
When used as directed, Subutex is a relatively safe medication to use as an aid for opioid detoxification with a low risk of overdose. However, if obtained illegally or misused in any other way, it is possible to overdose on this substance.
As Subutex only partially binds to opioid receptors in the brain, the chances of respiratory depression are significantly lowered when compared to other opioid-based substances. The danger occurs primarily when Subutex is combined with other drugs such as alcohol and other opioids, which can cause a sedative effect that can result in loss of consciousness and potentially death.
Common signs of a Subutex overdose include:
- Extreme confusion
- Yellowing of the eyes and skin
- Dark-coloured urine
- Pinpoint pupils
- Severe pain in the abdomen or extremities
- Convulsions and seizures
If you are concerned that you or someone you know may be suffering from a Subutex overdose, call 999 and seek medical assistance immediately. It is important that you report all substances ingested, even if you think they may be illegal, as this can help the medics to provide the correct treatment.
How can I access Subutex?
As Subutex an opioid-based medication and therefore potentially addictive, it is only possible to obtain through a prescription.
A thorough medical assessment must be performed before Subutex can be prescribed in order to ensure that the patient is physically and mentally healthy enough to receive this treatment. This will include a number of questions regarding the patient’s general lifestyle and social circumstances, including any other substance use and co-occurring mental health disorders. A physical examination may also be performed, with blood and liver function tests taking place along with a drug test to confirm that no other substances are being ingested.
If the assessment finds that Subutex would be beneficial as part of a heroin or opioid detox, the prescription will then be issued.
If you believe you would benefit from Subutex as part of heroin or another opioid detoxification plan, speak to your GP who will be able to refer you to a community drug team for an assessment if they do not have the training and resources to do this themselves.
References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853172/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994593/
[3] https://www.gov.uk/penalties-drug-possession-dealing
