Table of Contents

I. The Basicsof of Subutex Addiction

This guide explains the effects, trends, and dangers of Subutex use and provides an unbiased analysis of the medicinal and behavioral treatment methods for Subutex addiction based on current research and publicly available statistics. In some cases, usage statistics are derived from general non-heroin opioid use, which includes Subutex, buprenorphine, and other prescription opioids.

Primary Subutex Dangers

  • Addictiveness. Whether or not buprenorphine poses a significant risk for prolonged addiction when it’s used to treat someone for opioid dependency is still debated among providers with different opinions on the matter. However, in 2007, Nutt et al. evaluated the addictive potential of a number of substances, including buprenorphine. On a scale of 0 to 3, experts rated buprenorphine 1.5 for both physical and psychological dependence. Drugs that scored higher included tobacco, benzos, alcohol, street meth, barbiturates, and heroin. Drugs that scored lower included LSD, solvents, and ecstasy.
  • Risk of overdose. While Subutex’s impact on the respiratory system is not as strong as the impact of other opioids, it does change how the body functions. As such, it’s possible for someone to overdose on this drug. To understand the overall risk of overdose with Subutex, consider this fact: In one year, the Tennessee Department of Health found that 67 overdose cases were related to buprenorphine. That’s compared to more than 1,200 total overdose cases related to opioids.
  • Unintended side effects. Subutex does have some potential side effects, which can include headaches, digestive distress, chills, anxiety, depression, and problems sleeping. Other side effects can include a cough, watery eyes, runny nose, and increased risks of infection. In the most extreme and rare cases, Subutex can lead to liver damage or failure.
  • Legal risks. Subutex is a Schedule III drug. Possession without a valid prescription can come with a penalty of up to a year in prison and a monetary fine of $1,000 or more. Being found guilty of selling or distributing Subutex can mean up to 10 years in prison and a fine of up to $500,000.

Subutex Background Information

Derived FromSubutex is a brand name form of buprenorphine, which is a synthetic medication
Ways UsedIngested as a pill for medical purposes; abuse of the drug might include crushing the pill for snorting or liquifying it for injecting
Scientific NameBuprenorphine hydrochloride
Slang/Street Names for AdderallBig whites, Sobos, small whites, Subs, Sub, Stops
How Long in Bodily SystemHalf-life: 31-35 hours

Full elimination from the body can take up to a week

Punitive Legal Measures: Using/PossessionSubutex, and any form of buprenorphine, is a Schedule III drug. Possession of a Schedule III drug without a prescription is a charge that can result in up to a year of prison and a fine of $1,000 or more for a first offense. Second and third offenses can result in harsher sentencing.
Punitive Legal Measures: Selling/DistributingThe penalties for selling or distributing a Schedule III drug can be up to 10 years in prison and up to half a million dollars in fines for a first offense. That’s if no serious injury or death occurred related to the drug use; in cases where injuries occurred, the penalties can be harsher. Second or third offenses can result in even harsher sentencing.
DEA Drug RatingSchedule III

II. Signs of Abuse

Behavioral Symptoms of Subutex Usage and Abuse

How Subutex affects the brain

Subutex binds to receptors in the brain just like opioids do. It even has some of the same impacts as heroin or prescription opioids, which include causing euphoria, decreasing pain, and reducing respiration rates. But buprenorphine doesn’t bind to those receptors with the absolutely perfect fit that opioids boast. What that means is that when someone takes Subutex, the brain responds as if it has experienced opioids, but the full weight of the euphoric high and respiratory reduction doesn’t occur.

The reason this is a good drug to use in opioid addiction treatment is that once Subutex bonds to the brain receptor, another opioid will have trouble doing so. And since Subutex can stay bonded for up to three days, it serves multiple purposes. First, it causes the brain to think there is an opioid in the system. That reduces withdrawal symptoms and cravings for harder drugs such as heroin. Second, it reduces the effects of other opioids, making it less likely someone might abuse them while in treatment or recovery.

Behavioral signs of Subutex usage and abuse

But Subutex does offer some euphoric effects. If someone who has not built up a tolerance for opioids begins to abuse Subutex, that can be enough for them to get high. In some cases, people who are already addicted to opioids might take Subutex in ways that aren’t prescribed to get high, or they might divert their Subutex to others. That involves selling or trading Subutex for other types of drugs.

Behavioral signs of Subutex use or abuse can include:

  • Lying about how much Subutex was taken or seeking Subutex doses outside of a treatment plan
  • Stealing pills from someone else
  • Loss of interest in activities or hobbies that used to bring pleasure
  • Unexplained or sudden poor performance at school or work or failing to fulfill obligations
  • Changes in sleep or eating habits
  • Anxiety, depression, or mood swings

Physical Symptoms of Subutex Abuse

How Subutex affects the body

In addition to interacting with receptors in the brain, Subutex can have some impact on the body. It can have a slowing effect on the respiratory systems. However, because the receptor fit isn’t perfect, this effect is typically limited and not as severe as it can be with other opioids. That’s especially true when Subutex is being taken as part of a monitored treatment program. However, when the drug is abused, those effects can reach dangerous overdose levels.

Other potential side effects of Subutex can include headache, vomiting or nausea, trouble sleeping, some aches and pains, and peripheral edema, which is swelling in the extremities. In very rare cases, Subutex side effects have included more serious issues such as liver failure, low blood pressure when someone stands up, and allergic reactions.

Early physical effects of Subutex

When taken as prescribed, the immediate physical effect of Subutex is a quelling of withdrawal symptoms. When abused, Subutex can cause a feeling of euphoria and potentially minor pain relief.

This table illustrates the possible short-term physical effects associated with Subutex.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.)Feelings of euphoria or extreme wellness
Some loss of pain
Potentially slower breathing
Lingering (within an hour of taking the drug)The effects above may begin to wear off
Side effects such as headaches or stomach distress may occur
Post-Use (several hours to days after use)Cravings for opioids or Subutex
Opioid withdrawal symptoms as the medication wears off

Severe and long-term physical effects of Subutex

The most severe side effects of Subutex are the potential for liver failure or death. The risk of these issues increases when someone is abusing Subutex as compared to the risks when taking the medication as part of a supervised treatment program.

This table illustrates the possible long-term physical effects associated with Subutex.
Long-Term Physical Symptoms
CasualHeadache
Changes in sleep
Minor aches and pains
Chronic

Including all of the above effects for casual use

Diminished liver function
Changes in blood pressure
WithdrawalShaking
Digestive distress
Restlessness
Anxiety
Runny nose
Aches and pains
Numb or red mouth

Further Resources

The Drug Enforcement Agency has published a comprehensive printable sheet about buprenorphine. The Substance Abuse and Mental Health Administration also has information about buprenorphine and other medications commonly used to treat opioid addiction.

III. Subutex Usage

Subutex and buprenorphine availability increased in the past two decades

In 2003, only around 10% of opioid treatment programs provided buprenorphine as an option. As awareness of these drugs and their potential for helping people recover from opioid addiction spread, so did availability. By 2014, more than 90% of opioid treatment programs provided buprenorphine to at least some patients.

The increase in availability led to an increase in abuse

The government does put limits on how many patients each physician can prescribe buprenorphine to at any given time. This is due in part to the Schedule III nature of the drug. Lawmakers don’t want to flood the market with Subutex and similar drugs because of the risk that these medications will be diverted. Diversion refers to the use of legal prescription medications outside of a treatment plan and in illegal ways. According to the National Institute on Drug Abuse, buprenorphine and methadone only account for around 15% of the reported diverted drugs in the United States. Prescription painkillers, such as hydrocodone and oxycodone, are much more likely to be diverted.

Even with the regulations, however, the increased availability of the drugs led to increased abuse. The Drug Abuse Warning Network reports that emergency room visits related to buprenorphine were around 3,161 in 2005. By 2010, that number had climbed to 30,135 — just over 50% of those visits related to abuse of the drug.

Often, diversion starts as a way to control opioid withdrawals

According to the NIDA, many people who engage in the use of diverted buprenorphine do so to help control their opioid withdrawal symptoms. Perhaps these people are not able to get a prescription for Subutex due to legal limitations, or they are attempting to try to manage their own detox. Either way, this can be dangerous as more than 40% of emergency room visits related to overdose or misuse of buprenorphine involved people attempting to use it in this manner without medical oversight.

IV. How to Find Help

Subutex is a unique drug in that it can help someone overcome a life of addiction while leading someone else into that life. Whether you’re taking Subutex in rehab and having a hard time tapering off properly or you have abused Subutex and developed a physical dependency, getting professional help is important. Opioid addictions of any kind can be extremely difficult, if not impossible, to manage alone. Even though the effects of Subutex are milder than those of pure heroin or prescription opioids, they can cause your body to become heavily physically dependent. Subutex was also rated 1.5/3 when it comes to psychological dependency, which means it can be mentally and emotionally difficult to quit.

All of this means it’s important to look for a treatment provider who understands your addiction and is experienced in treating Subutex dependency. Treating this addiction is a multistep process that may involve tapering off the drug use or stopping it immediately and supporting you with various forms of counseling. When speaking to potential rehab or addiction treatment providers, ask about their preferred approach to treating Subutex addiction to make sure it aligns with your own goals for recovery. For more information, read our Subutex rehab guide.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention

1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.