Tapering off Subutex
Buprenorphine is a lifesaver for tens of thousands of people each year. The medication is prescribed as an addiction-management tool for individuals undergoing treatment for substance use disorders linked to opioid and opiate use. While buprenorphine is the drug’s official name, most are more familiar with its other moniker: Subutex.
To better understand Subutex, it is best to delve deeper into what exactly its purpose is. Opioids like hydrocodone, fentanyl and heroin can operate as painkillers, or provide euphoric highs. At the chemical level, these compounds break down and bind themselves to opioid receptors in the brain to produce this pain-relieving effect. Subutex also binds to these receptors. The medicine contains a mechanism to both partially bind and partially block the receptor, stunting the effectiveness of opioids in these regions of the central nervous system. The binding action placates cravings with the minimum amount of opioids necessary to achieve any sensation, without creating the nasty aftermath of further dependence. Subutex replaces and satiates without enabling: it gives the brain what it wants in the short term while preparing it for long-term treatment.
Suboxone. No, that wasn’t a spelling error. It’s actually another variant of buprenorphine administered to replace and treat opioid use. Similar names, similar functionality — but just what are the differences between Suboxone and Subutex? The answer: not very many. In fact, beyond a few differences in additives, the drugs are one and the same. Except, Suboxone has a secret weapon in its opioid-addiction arsenal. That compound is naloxone. Naloxone blocks opioid overdoses when used alone and, in the case of Suboxone, mirrors withdrawal symptoms if a patient attempts to take the pill incorrectly. In other words, it’s a synthetic safeguard of sorts. Subutex lacks this additional layer, and that can be somewhat problematic.
The trouble is, in some patients, Subutex can result in negative outcomes all its own. While generally considered less likely than with other opioid-treatment drugs like methadone, a substance use disorder can develop after long-term Subutex use or misuse. An interesting yet ironic scenario emerges: Subutex is used to detox opioids but may eventually require detox itself. That irony is not lost on someone who has overcome one personal opioid crisis just to be faced with another.
Rehabilitation centers across the United States implement detoxification methods for Subutex. One such method is known as tapering. Now, one must first realize that any online inquiry into tapering off Subutex will lead to some unintended results. This is because a Subutex taper can be misinterpreted as being an opioid taper using Subutex as a replacement therapy medicine. Unhelpful? Yes. Frustrating? Absolutely. But this should never falter any attempt to identify a true Subutex taper regimen if one is necessary. Not only do they exist, but they are immensely effective in ridding patients of their unwanted Subutex habits. With the assistance of a Subutex taper chart and a medical doctor, tapers can be the road to recovery a patient has searched for.
There is another matter that must be discussed. In no way is a Subutex taper the same as quitting cold turkey. These two concepts are fundamentally different. Going cold turkey is analogous to diving head first into a withdrawal, one that is at its most painful and can last months. Subutex taper charts don’t advocates stopping dosages cold turkey— and the point of the matter is, neither do most medical professionals. Successful detoxes require structure. Successful tapers require time. Successful recoveries require support. Cold turkey satisfies none of the above.
After completing any previous opioid treatment, tapering off Subutex may follow suit. By their very nature, tapers are incremental and gradual beasts. They must be undertaken slowly for fear of awakening dormant withdrawal symptoms that eagerly wait at the surface for any slipups. No two Subutex taper charts look exactly the same. This is because each patient will have different biological, emotional and psychological needs. A chart can be months-long if necessary. An example of one such schedule may be:
Starting Subutex Dosage Prior to Treatment: 20 mg/day
Day 1: Reduce to 12 mg/day
Day 6: 12 mg/day to 8 mg/day
Day 11: 4 mg/day
Day 16: 2 mg/day
Day 24: 1.50 mg/day
Day 31: 1 mg/day
Day 39: 0.75 mg/day
Day 45: 0.50 mg/day
Day 51: 0.25 mg/day
Day 56: 0.13 mg/day
Day 60: 0 Subutex doses
With proper guidance, grit and a dash of good fortune, a Subutex taper will go off without a hitch — and the patient is free to reap the benefits of recovery.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
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